Radiofrequency thermal treatment with chemoradiotherapy for advanced rectal cancer.

学位記番号：医博乙140

A hyperthermic perfusion therapy using peplomycin and ethanol for bladder cancer

10例の膀胱癌症例に対し, エタノール加ペプロマイシン灌流による膀胱癌温熱療法を施行し, うち6例に25%以上の腫瘍縮小効果が認められた.しかし腫瘍の完全消失例が認められなかったことにより, 本療法による根治性は否定的と考えられたDistilled water containing 40 micrograms/ml peplomycin and 2% ethanol was used as a perfusate in 8 patients with superficial bladder tumors and 2 with deep bladder tumors for 2 hours at 43 degrees C. In addition, immediately before the perfusion treatment, 5 mg of peplomycin was injected intramuscularly. Prior to treatment, the nature and extent of the tumors were determined by ultrasonography, cystoscopy and cystography. The therapeutic effect of the hyperthermic perfusion was evaluated by the same manner as used previously. Partial tumor regression was obtained in 6 of the 8 patients with superficial bladder tumors. The 2 patients with deep bladder tumors showed no tumor regression. Most of the patients had bladder discomfort such as irritation, pollakisuria and so on, during and/or after perfusion. No patient developed acute pyelonephritis

Conservative therapy by percutaneous radiofrequency ablation of renal cell carcinomas - therapeutic experiments of four patients with seven renal tumors -

腎細胞癌4症例(平均59歳, 男女各2例)の7腫瘍に対してCTガイド下に経皮的ラジオ波焼灼術(RFA)を行った.全例, imperative caseであった.2例はvon-Hippel Lindau(VHL)病に伴う遺伝性多発性腎細胞癌で, 他の2例は両側同時発生例, 原因不明の胸水に伴う呼吸機能障害例であった.腫瘍の平均径は4.5cmで, 最高出力は平均94W, 最高温度は平均82℃, 焼灼時間は平均11分, 手術時間は平均91分であった.平均観察期間6.3ヵ月における外方突出型3症例の局所制御率は42.9%(3/7腫瘍)であった.VHL病を持った2例には, 肺転移, 膵転移, 腫瘍の成長がみられた.合併症に重篤なものはなく, 疼痛, 嘔気, 腎被膜下血腫, 微熱などであった.腎細胞癌に対するRFAは, 症例によっては低侵襲, かつ良好な局所制御が可能であるが, 適応には慎重な検討が必要だと考えられたWe report 7 renal cell carcinomas in 4 patients treated by percutaneous image-guided radiofrequency ablation (RFA). The mean age of the patients was 59 years (male: 2, female: 2). All 4 were imperative cases. Two patients (5 tumor) had hereditary multiple renal cell carcinomas with von Hippel-Lindau (VHL) disease. The other two patients had sporadic renal cell carcinomas. RFA was performed guided by computed tomography under conscious sedation with local anesthetics. The mean size of the treated tumors was 4.5 (1.8-8.1) cm. Impedance-regulated RF energy from a generator at 94 (45-130) watts was applied at 11 (8-14) min intervals. The average procedure time was 91 (45-165) minutes. The maximum tissue temperature reached 82 (56-91) degrees C immediately after ablation. Three of the 7 lesions (42.9 %) were locally well controlled during the mean follow-up period of 6.3 (4-9) months. The two patients with VHL disease developed visceral metastasis after There were no major complications. Minor complications encountered included flank pain, nausea, perinephritic hematoma and fever. Although percutaneous image-guided RFA showed limited success in large or central renal tumors, the therapy against small exophytic renal tumors would be well tolerable and successful

Current status of the conservative treatment of urinary bladder for invasive bladder cancer

浸潤性膀胱癌11例を対象とした.治療前, T2が5例, T3が3例, T4が3例, TCC grade 2が8例, TCC grade 3が2例, TCC grade 3+anaplastic carcinomaが1例であった.8例では心疾患をはじめとする合併症がみられた.前治療としてradiationやTUR, 化学療法などを受けていた.HPC-adriamycin, radiationなどを併用してハイパーサーミアをおこなったところ, CRが4例, PRが4例, NCが2例, PDが1例という成績がえられた.PRの4例中,During the 3 years from 1987 to 1990, we gave hyperthermia to 11 of the patients who visited our department for the treatment of invasive bladder cancer. Results and prognosis are reported. Stage and grade of the cancer before the treatment in 11 cases were T2 in 5 cases, T3 in 3 cases, T4 in 3 cases, transitional cell carcinoma (TCC) grade 2 in 8 cases, TCC grade 3 in 2 cases, and TCC grade 3 + anaplastic carcinoma in 1 case. Complications were observed in 8 of the 11 cases, such as severe heart disease and others. Pretreatment of radiation therapy, transurethral resection or chemotherapy was given in all cases. Hyperthermia was performed combined with hydroxypropyl cellulose-(HPC)-adriamycin, or radiation therapy, and the following results were obtained: complete response (CR) in 4 cases, partial response (PR) in 4 cases, no change (NC) in 2 cases and progressive disease (PD) in 1 case. Among 4 cases of PR, total cystectomy was performed in 3 cases. These 3 cases and the 4 cases of CR are alive now, but the other 4 patients died

温熱療法

Article信州医学雑誌 38(5): 435-442(1990)journal articl

Significance of Procalcitonin Measurement in Cases with Febrile Condition during Chemotherapy for Urological Cancer

We examined the usefulness of measurement of procalcitonin (PCT) for patients, who developed febrile neutropenia during cancer chemotherapy for urological cancer. Of the Patients who underwent cancer chemotherapy for bladder, renal pelvic or ureteral, and testicular cancer in our department from 2010 to 2013, 51 had febrile events. Their clinical courses and PCT values were retrospectively reviewed and analyzed. PCT was positive in 12 patients and negative in 39. The duration with febrile status was significantly longer in the PCT-positive group than in the PCT-negative group. There was no significant difference between the blood count values in each group, but C-reactive protein (CRP) was significantly higher in the PCT-positive group than in the PCT-negative group. There were no significant differences between the 2 groups in other tests with blood. There were 12 patients with febrile neutropenia (FN) but all were classified into low-risk by the MASCC scoring system. Four of these 12 patients were positive for PCT. Our results suggested that, in patients with a fever of 37.5°C or more during the course of cancer chemotherapy for urologic cancer, bacteremia possibly existed if the patient was positive for PCT. In addition, the duration of fever tended to be longer and the condition was more severe. When the patients with urological cancer undergo cancer chemotherapy manifest high-grade fever, PCT is promising and valuable as an indicator of the severity of infection