【网学提醒】：本文主要为网上学习者提供体外循环全身热灌注治疗恶性肿瘤的疗效及安全性评估，希望对需要体外循环全身热灌注治疗恶性肿瘤的疗效及安全性评估网友有所帮助，学习一下吧!
资料包括： 论文(6页4893字)
说明：
【摘要】 目的 评估体外循环全身热灌注（EWBH）治疗复发、转移性肿瘤的疗效及安全性，观察其对全身各主要组织器官的损伤情况。方法 监测60例2002年6月～2004年6月EWBH联合化疗的各类复发、转移性肿瘤病人术中各测温点的温度及相应的血液成分、肝、肾等脏器功能指标的变化，观察EWBH的安全性及对各组织器官的损伤；选择同期相同肿瘤类型及其化疗方案的病人45例作为对照组，比较EWBH组与对照组的疗效。结果 EWBH治疗复发、转移性肿瘤病人的有效率(CR+PR+SD)为72.6%，PD 为 27.4%，血液相关肿瘤指标下降率为72.6%，肿瘤疼痛缓解率70.2%，体重增加率50.0%，睡眠改善率56.7%，术后KPS评分提高66.1%。一年生存率51.2%，半年生存率80.4%，明显高于对照组(P＜0.05)。该疗法升控温平稳安全。结论 EWBH过程是平稳安全的，不会造成患者重要组织器官的损害，对治疗肿瘤有其不可忽视的疗效。
【关键词】 体外循环全身热灌注治疗,化疗,恶性肿瘤,疗效,安全性
Assessment of the effects and clinical safety of the treatment of advanced malignant tumor with extracorporeal whole body hyperthermia
【Abstract】 Objective To assay the primary effects and clinical safety of the treatment of advanced malignant tumor with extracorporeal whole body hyperthermia(EWBH)，and to evaluate the impairment of it to the vital organs and tissues.Methods 60 patients of advanced malignant tumor were treated with EWBH and chemotherapy from June 2002 to June 2004， while the control group (n=45) with same spectrum and same stage of tumors were treated with similar chemotherapy alone. We assayed the primary effects of EWBH through comparing with controls. The stability and safety of EWBH in monitoring and controlling the body temperature were evaluated by real-time temperature measurement as well as the impairments of vital organs and tissues， such as brain， liver， kidney and lung， were by examination functional index of body peripheral blood.Results (1) The effective rate (CR+PR+SD) of EWBH and chemotherapy was 72.6% on treating advanced malignant tumor， PD was 27.4%， the descent rate of index concerning tumor (as AFP， CER， CA199， CA242， CA125 and so on) was 72.6 %， the rate of pain relieve was 70.2%， the percentage of cases， whole body weight had increased post-EWBH after four weeks， reached 50.0%， and that of those appetite advanced was 76.5%， of those sleep improved was 56.7%. The indexes of Karnofsky was increased. 66.1%.51.2% patients alive were over one year and 80.4%over half one year. All of them are better than controls (P＜0.05). (2)Although there are some impairment on function and tissues in the vital organ， the damage is venial and reversible. (3) The method of EWBH is steadily and safe on monitoring and controlling body temperature.Conclusion EWBH can make some reversible impair to the some vital organs and tissues， the whole procedure is steady and safe as one of hyper thermia therapy to the malignant tumor. EWBH can improve the patients live quality and prolong their life.
【Key words】 extracorporeal；whole body hyperthermia；chemotherapy；malignant tumor；effect；safety
目录：
1 资料与方法
2 结果
3 讨论
参考文献：
1 Westermann AM， Grosen EA， Katschinski DM， et al. A pilot study of whole body hyperthermia and carboplatin in platinum-resistant ovarian cancer. Eur J Cancer，2001， 37(9)：1111-1117.
2 Kerner T， Deja M， Ahlers O， et al. Whole body hyperthermia： a secure procedure for patients with various malignancies? Intensive Care Med， 1999， 25： 959-965.
3 Manjili MH， Wang XY，Park J， et al. Immunotherapy of cancer using heat shock proteins. Front Biosci， 2002， 7：43-52.
4 Srivastava PK， Amato RJ. Heat shock proteins： the ‘Swiss army knife’ vaccines against cancers and infectious agents. Vaccine， 2001， 19： 2590-2597.
5 Awaji Y， Sato T， Seiki M， et al. Heat shock-mediated transient increase in intracellular3’，5’-cyclic ampresults in tumor specofic suppression of membrane type 1-martix metalloproteinase production and progelatinase a activation. Clin Exp Metastasis， 2000， 18： 131-138.
6 Evans SS， Wang WC， Bain MD， et al. Fever-range hyperthermia dynamically regulates lymphocyte delivery to high endothelial venules. Blood， 2001， 97：2727-2733.
7 Burd R， Dziedzic TS， Xu Y， et al. Tumor cellapoptosis lymphocyte recruitment and tumor vascular change are induced by low temperation， long due/ration (fever-like) while body hyperthermia. J Cell Physiol， 1998， 177：137-147.
8 Huang GW， Masanori S， Li JE， et al. The relationship between microvessel density the expression of vascular endothelial growth factor(VEGF)， and the extension of nasopharyngeal carcinoma. Laryngoscope， 2000，110：2066-2069.
9 Sawaji Y， Sato T， Takeuchi A， et al. Anti-angiogenic action of hyperthermia by suppressing gene-expression and production of tumour-derived vascular endothelial growth factor in vivo and invitro. Br J Cancer， 2002， 86：1597-1603.
10 Wiedemann GJ， Robins HI， Katschinski DM， et al. Systemic hyperthermia and ICE chemotherapy for sarcoma patients： rationale and clinical status. Anticancer Res， 1997，17：2889-2902.
11 Hildebrandt B， Wust P， Ahlers O， et al. The cellular and molecular basis of hyperthermia. Crit Rev Oncol Hematol， 2002，43：33-56.
12 Katschinski DM， Wiedemann GJ， Mlongo W， et al. Whole body hyperthermia cytokine induction： a review， and unifying hypothesis for myeloprotection in the setting of cytotoxic therapy. Cytokine Growth Factor Rev，1999，10：93-97.
13 Sminia P， Zee J， Wondergem J， et al. Effect of hyperthermia on the central nervous system： a review. Int J Hyperthermia， 1994， 10： 1-30.
