Ipertermia e coinvolgimento pericardico da tumore polmonare
Ancora una evidenza di efficacia dell'ipertermia.
Un lavoro Cinese testimonia la maggiore efficacia di un trattamento combinato di ipertermia e chemioterapia rispetto alla sola chemioterapia nel trattamento di coinvolgimento pericardico da tumore polmonare.
I risultati della combinazione sono circa doppi rispetto alla sola chemioterapia.
Dr. Carlo Pastore
Zhongguo Fei Ai Za Zhi. 2011 Jul 20;14(7):593-7.
Efficacy of Radiofrequency Hyperthermia Combined with Chemotherapy in Treatment of Malignant Pericardial Effusion Caused by Lung Cancer.
[Article in Chinese]
Luo P, Cao P, Yao Z.
Department of Medical Oncology, the Third Xiangya Hospital of Central South University, Changsha 410013, China.
Malignant pericardial effusion is one of the serious complications of lung cancer and lack effective treatment methods. The aim of this study is to evaluate the efficacy and safety of radiofrequency hyperthermia combined with chemotherapy for patients with malignant pericardial effusion caused by lung cancer.
Fifty-five patients with malignant pericardial effusion caused by lung cancer were divided into hyperthermia combined with chemotherapy group (combined therapy group) and chemotherapy group. The combined therapy group was treated with radiofrequency hyperthermia after the pericardiocentesis and intracavitary injection (cisplatin 20 mg and dexamethasone 5 mg), when patients' general state of health improved, systemic chemotherapy was performed. The chemotherapy group was treated only with intracavitary injection and systemic chemotherapy. Intracavitary chemotherapy was performed for 1-6 times (average 3 times). Hyperthermia was performed twice per week with an average of 6 times following intracavitary and systemic chemotherapy. The temperature of intracavitary was 40.5 °C-41.5 °C for 60 min during the hyperthermia periods. Systemic chemotherapy consists of cisplatin (75 mg/m²) and vinorelbine (50 mg/m²).
The complete remission rate (CR) of malignant pericardial effusion was 54.3% and the response rate (RR) was 91.4% in the combined therapy group, while the rates of CR and RR of chemotherapy group were 25.0% and 70.0%, and the differences of CR and RR between the two groups were significant (P<0.05). After treatment, the quality of life improved significantly in both groups, but the combined therapy group had a higher KPS score than in the chemotherapy group (P<0.05). The adverse events associated with the chemotherapy included gastrointestinal toxicity and myelosup-pression, and there were no significant differences between the two groups. The main side effects associated with radiofrequency hyperthermia included local skin ache (8.6%) and induration of subcutaneous fat (5.7%).
Radiofrequency hyperthermia combined with chemotherapy is effective in treatment of malignant pericardial effusion and can significantly improve the quality of life of patients without increasing the toxicity of chemotherapy, and side effects could be tolerable.