基于患者背景选择患者进行热疗治疗

Naoyuki Sakamoto, S. Kokura, T. Ishikawa, M. Tanigawa, Y. Naito, T. Yoshikawa
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摘要

使用热疗作为癌症治疗通常是不可能立即继续由于癌症生长的一般情况恶化。然而,关于热疗的可接受性还没有正式的共识,因此热疗患者的选择并不是基于商定的临床标准。本报告旨在建立关于热疗患者选择的一致临床标准,在癌症晚期治疗前根据患者背景检查热疗的治疗可接受性。研究对象包括45名在2008年7月至2009年5月期间就诊的各种晚期癌症患者,他们接受了局部热疗联合化疗或免疫治疗。A组(n=24)热疗≥8次,B组(n=21)热疗≤7次(平均4.19次)。我们调查了预处理实验室数据、体重指数、运动状态(PS)、格拉斯哥预后评分(GPS)和生活质量(QOL)。PS和GPS评分均较差的患者较早退出。在这些患者中,除了低白蛋白血症外,乳酸脱氢酶(LDH)和c反应蛋白(CRP)水平也趋于升高。B组患者的生活质量在热疗开始前就已受损。在判断热疗的可接受性时,PS和GPS似乎是最重要的因素,而LDH、CRP和白蛋白水平可能有助于这种判断。热疗的可接受性可以通过实验室数据和癌症治疗前的一般情况(包括生活质量)证明的患者背景来预测。结果证明了在大量患者中进一步检查的理由,目的是建立关于热疗患者选择的一致临床标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Selecting Patients for Hyperthermia Treatment Based on Patient Backgrounds
Use of hyperthermia as cancer treatment has often been impossible to continue at once following exacerbation of general condition due to cancer growth. However, no formal consensus has yet been defined regarding the acceptability of hyperthermia, so selection of patients for hyperthermia is not based on agreed clinical criteria. Aiming at the establishment of agreed clinical criteria concerning the selection of patients for hyperthermia, this report examined the treatment acceptability of hyperthermia based on patient backgrounds before advanced cancer treatment. Subjects comprised 45 patients with various advanced cancers treated with regional hyperthermia combined with chemo- or immunotherapy who visited our clinic between July 2008 and May 2009. Group A (n=24) underwent hyperthermia ≥ 8 times, while Group B (n=21) underwent hyperthermia ≤ 7 times (mean, 4.19 times). We investigated pretreatment laboratory data, body mass index, performance status (PS), Glasgow prognostic score (GPS), and quality of life (QOL). Patients with poor scores for both PS and GPS dropped out early. In these patients, elevations in both lactate dehydrogenase (LDH) and C-reactive protein (CRP) levels tended to be present in addition to hypoalbuminemia. QOL in Group B was already impaired before initiation of hyperthermia. PS and GPS appear to represent the most important factors when judging the acceptability of hyperthermia, while LDH, CRP, and albumin levels may help such judgments. The acceptability of hyperthermia can be predicted using patient background as evidenced by laboratory data and general conditions, including QOL, before cancer treatment. The results justified further examination in a large number of patients to aim the establishment of agreed clinical criteria concerning the selection of patients for hyperthermia.
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