体外射频透热配合放射治疗对癌性心包积液的疗效分析  

Clinical analysis of combined hyperthermia and radiotherapy for patients with malignant pericardial effusion

作　　者：刘跃[1] 张国桥[1] 王永刚[1] 

机构地区：[1]中国人民解放军成都军区昆明总医院肿瘤科,云南昆明650032

出　　处：《现代肿瘤医学》2009年第1期53-55,共3页Journal of Modern Oncology

摘　　要：目的:探讨高频透热治疗配合常规放疗治疗癌性心包积液的临床效果。方法:82例恶性心包积液,男性35例,女性47例;年龄38-72岁,中位年龄64.5岁。所有原发肿瘤经病理学确诊,其中肺癌38例、乳腺癌35例、恶性淋巴瘤7例、胸腺恶性肿瘤2例。34例进行了高频透热治疗配合常规放疗,采用电容式HG-2000型体外高频热疗机,频率13.56MHz,最大输出功率600W,加热靶区温度42℃-43℃,治疗时间30-50min,每周2-3次,治疗8-12次,中位次数10次。放疗在热疗后20-120分钟进行,每天2Gy、每周5次,总剂量30-46Gy,中位剂量42Gy。单独放疗48例,采用常规照射方式进行,每天2Gy、每周5次,总剂量34-56Gy,中位剂量46Gy。所有病例在治疗后观察2-4个月,并定期随访。结果:治疗效果:体外高频透热治疗配合体外放疗组:CR 6例,PR19例,NC9例,有效率73.53%(25/34)。单独放疗组:CR 3例,PR 20例,NC 25例,有效率47.92%(23/48),P<0.05。生活质量改善情况:高频透热治疗配合放疗组,改善率79.41%(27/34)。单独放疗组,改善率54.16%(26/48),P<0.05。中位无进展生存期分别为9个月及5个月。结论:恶性心包积液用射频透热治疗配合放射治疗是一种较好的治疗手段。Objective：To study the effect of combined hyperthermia and radiotherapy for malignant pericardial effusion. Methods： Thirty four cases of malignant percaridial effusion were treated by hyperthermia combined with conventional radiotherapy. The patients received 2 - 3 times of hyperthermia treatment per week with 13.56 MHz radiofre- quency during conventional fractionation radiotherapy, the power of hyperthemia was 600 watt and TEM 42 ~C -43 ~C. Hyperthermia was given for 30 -50 minuts within 20 - 120 minuts following irradiathion with 8 - 12 session of hyper- thermia （average 10 sessions per patient）. The total dose of radiotherapy was 30 -46 Gy,at the 200 cGy per fraction; 48 patents were treated by conventional radiotherapy alone. Results：The overall response （complete response 6 pa- tients ＋ partial respone 19 patients ） rate was 73.53 % （25/34） in hyperthermia combined with conventional radio- therapy group and 47.92% （23/34） in conventional radiotherapy group, P 〈 0. 05. The vitality ameliorated was 79.41% （27/34） in hyperthermia combined with conventional radiotherapy group and 54.16% （26/48） in conven- tional radiotherapy group,P 〈 0.05. The median survivals were 9 months in hyperthermia combined with conventional radiotherapy group and 4 months in conventional radiotherapy group. Conclusion：Combined hyperthermia and radio- therapy can improve the life quality and survivals time of malignant pericardial patients.

关 键 词：心包积液 放疗 热疗 

分 类 号：R730.5[医药卫生—肿瘤]