Interstitial Thermoradiotherapy for Metastatic Lymph Node of the Neck.
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概要
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Since August 1988 eight patients with unresectable cervical lymph node metastasis received a combination of interstitial Iridium-192 radiotherapy and interstitial 915MHz microwave hyperthermia supplemented by external radiotherapy. Interstitial hyperthermia was applied immediately prior and after Iridium-192 radiotherapy (25-43Gy) for 40 min. at temperature of 42°C. Microwave antennas were inserted into afterloading tubes that has been implanted in tumors using conventional interstitial implantation techniques for Iridium-192 radiotherapy. External radiotherapy of 35-50Gy was performed before the interstitial treatment. Total radiation dose ranged from 65 to 83 Gy.<BR>Initial response at 3 months follow-up showed 1 (13%) complete response, 6 (75%) partial response and 1 (13%) no change. Seven patients were dead and one (thyroid papillary carcinoma) is alive. Tumor regrowth were detected in 4 patients and 3 of them were considered to be dead by distant metastases.<BR>These results of thermoradiotherapy were compared with those of radiotherapy that was consisted of external radiotherapy and interstitial Iridium-192 radiotherapy for metastatic cervical lymph nodes. Tumor response and nodal control rate were no better than that of radiotherapy alone, but subcutaneous fibrosis were less severe in those treated by thermoradiotherapy.<BR>In conclusion, it seemed that interstitial thermoradiotherapy was one of the best available treatment modalities for unrerectable metastatic cervical lymph node.
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