大功率微波热疗联合化疗和放疗治疗髋关节骨肉瘤.pdfVIP

· 658· 2008军06月笫25卷第06期 Prac J Med＆Pharm．Vol 25．2oo8—06 No． 临床研究 大功率微波热疗联合 · 论 著· 化疗和放疗治疗髋关节骨肉瘤 贺会江① 贺慧芳② 陈培端① 章岳山① 黄传继① (~150医院肿瘤诊疗中心，河南洛阳 471031；②’洛阳铜加工集团医院内科，河南洛阳 471039) 【摘 要】目的 探索用大功率微波热疗结合大剂量甲氨喋呤(HD—MTX—CF)和放疗治疗髋关节骨肉瘤 的新疗法。方法 先以HD—MTX—CF为主，联合长春新碱(VCR)和阿霉素(ADM)化疗1 2周期，继用 6My直线加速器对髋关节病灶照射，放疗剂量DT：7 000—8 O00cGy，再以HD—MTX—CF为主巩固化疗2 3 周期，结合UHR一915MHz大功率微波热疗机对病灶进行加热(化疗时结合热疗 1—2次倜期；放疗时结合 热疗1 2次倜)，每次加热时间90—120min，温度40—42℃，热疗时对鼓膜、食管和直肠进行测温。结果 12 例患者，生存时间7个月至1O年，中位生存时间25个月，局部控制率为100％，生存最长2例为无瘤生 存。不良反应以白细胞下降、消化道反应及轻度药物性肝损害多见；药物性肝损害表现为A 、AST增高， 可于短期内恢复。结论 大功率微波热疗结合大剂量甲氨喋呤和放疗治疗髋关节骨肉瘤疗效好．不良反 应少。值得临床推广。 l关键词】髋关节骨肉瘤 微波热疗 大剂量甲氨喋呤 放疗 l中图分类号】R730．262：R738．2 【文献标识码】A HigU power microwave hyperthermia combined witlI HI)一MTX and radiotherapy for hip joint osteosarcoma HE Hui-jiang~,HE Hui-fang，CHEN Pei—duan，et a1．Tumor Diagnosis and Treatment Center，No．150 Hospital of PLA，Luoyang 471031，China 【Abstract1 Objective To search for a new therapy i．e with high power microwave hyperthermia combined with HD—MTX and radiotherapy in treating hip joint osteosarcoma．Methods There were 12 male patients．Firstly，1-2courses of chemotherapy，HD—MTX-CF combined with VCR and ADM； Secondly，6-My linear accelerator was used on hip joint focus；radiation dose was 7 000—8 000cGY． Then 2-3 courses of chemotherapy as the former．At the same time，the high power microwave hyperthermia with 9 1 5MHz Ofl hip joint focus was combined(1 or 2 sessions hyperthermia along with chemotherapy a course；1 or 2 sessions hyperthermia along with radiotherapy a week)．The temperature was keeped 4O—42℃ for 90-120min per session．The temperature in tympanum．esophagus and rectum was detected in turn．Results The survival time was 7-10years．The median survival was 25mo