Intra-arterial infusion chemotherapy is widely used for inoperable metastatic liver cancer but the rate of success is not necessary high. To these patients, we used combined RF hyperthermia and intra-arterial infusion chemotherapy. If the temperature increase by external hyperthermia is insufficient, the effect of application of both modalities maybe small. A beagle male dog 13 kg weight, was operated under general anesthesia to open abdominal cavity and insert a catheter in the hepatic artery. External heating was preceded with Thermotro RF-8 and maintained the liver temperature 41.5°C for 5 minutes. Then saline which was exchanged in a 70°C water bath was infused at the speed of 400 ml/h for 10 minutes, 6 minutes after the infusing, the liver temperature was elevated by 1.5°C. Hot water infusing alone considerably high water temperature and fast infusing speed were necessary but when using both modalities the increase of liver temperature was easily achieved.

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当科にて, 1982年12月より1990年9月まで, 局所温熱化学療法によって27患者32腫瘍が治療された.32腫瘍の内訳は, 局所再発腫瘍19例, 肝転移7例, 肺転移2例, 悪性リンパ腫2例, 腹膜播種2例であり, 全例, 化学療法単独では効果を期待し難い局所進行例, あるいは放射線照射後または化学療法施行後の局所再発等の難治性腫瘍であった.8MHzRF誘電または430MHzマイクロ波加温装置を用い, 週1～2回, 1回当り30～60分の温熱治療を合計2～15回 (平均6.4±3.8回) 施行した.このうち1～6回 (平均3.0±1.5回) の温熱治療では, 加温直前または加温と同時に制癌剤を静注もしくは動注された.32腫瘍の一次効果は, CR2例 (6%), PR13例 (69%), NC11例 (34%), PD6例 (19%) であり, 一次効果の良好な症例程, 3ヵ月後の局所効果も良好であった.一次効果がCRまたはPRであった患者の生存率は, NCまたはPDであった患者の生存率より有意に高く, 腫瘍の深さ, 腫瘍内平均温度, 腫瘍内最低温度, 有効加温回数, 併用された制癌剤の種類数が, 一次効果に影響を与えた.また放射線治療や化学療法の既往のある病変に対しても, 各々11/15 (73%), 12/26 (46%) に, さらに以前に使用された制癌剤と同種の薬剤を再使用した場合5/13 (38%) に, 異種の薬剤を使用した場合7/13 (54%) に, CRまたはPRが得られた.以上より, 放射線治療を適用し難い症例や化学療法による制御の困難な症例に対しても局所温熱化学療法は適応になり得ると考えられる.

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We demonstrated an in vivo antitumor effect of thermochemotherapy using CDDP in BALB/c mice with Meth-A fibrosarcoma. The mice were divided into the following four groups : control, heat alone, CDDP alone and CDDP + heat. To assess the antitumor effect of treatment, immunostaining using anti-bromodeoxyuridine monoclonal antibody was employed. This was performed immediately, 3 hours, 6hours, 24 hours and 72 hours after treatment. Local hyperthermia was produced with a halogen lamp (43°C, 30min.). CDDP was administered intraperitoneally at a dose of 5mg/kg immediately prior to heating the tumor. Tumor temperature was measured with a thermistor placed at the center of the tumor.
The CDDP + heat group demonstrated a marked decrease of S phase tumor cells compared to other groups. This decrease of S phase cells started immediately after heating and persisted for a long period. In addition, the periphery of the tumor which initially appeared not to be injured demonstrated a prolonged decrease of S phase cells. Thus, thermochemotherapy using CDDP affected cell cycle progression of the tumor cells which appeared morphologically normal. These result suggest that the cytotoxicity of CDDP is activated by use in combination with hyperthemia and prevents cell cycle progression of tumor cells to the S phase.

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The paper is concerned with the new gel phantoms which can be used to visualize the high temperature region in a three-dimensional way. For the performance test or the maintenance of electromagnetic equipments for hyperthermia, it is desired to examine or check the three-dimensional pattern of the temperature distribution in the human body. In order to visualize the temperature distribution easily, the synthetic paste phantom has been used. The phantom is fabricated by dissolving the Polyvinyl Alcohol (PVA) into water and adding by a small amount of the surface active agent such as polyethylen glycol. The region whose temperature exceeds a certain value (clouding point) becomes white and opaque due to segregation of the agent. Thus the heated region whose temperature exceeds the clouding point can be visualized in the three-dimensional way. But the synthetic paste phantom has a serious problem of convection due to the temperature rise, because the phantom is a viscous fluid.
The new gel phantoms are transparent below the clouding point and the region which exceeds the clouding point becomes white and opaque. But convection due to the temperature rise does not occur in these phantoms. We have examined many kinds of high molecular gels to find suitable ones for the phantom. The materials we have found for the phantom materials are polyacrylamide and gellan gum. They show a good transparency to observe the white and opaque region from the outside and have high melting points. The clouding point can be controlled by changing the kind and concentration of the agent or by adding ionic materials such as a salt. The electrical properties of those phantoms can be adjusted to show the same properties as biological tissues by adding an appropriate amount of ionic material such as a salt. The newly developed phantoms may be quite useful for hyperthermia, because they enable us to observe the temperature region above 42.5°C in a three-dimensional way.

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10例の前立腺肥大症患者に対して, Thermotron RF-8によるハイパーサーミアをおこない, その治療効果をみた.対象症例全例がこの治療前にcernitin pollen extract, chlormadinone acetate, α-blockerなどの薬剤を6ヵ月以上投与されていた.また6例に合併症として神経因性膀胱機能障害, 前立腺炎, 神経痛などを認めた.治療は外来で, 無麻酔でハイパーサーミアをおこなった.ハイパーサーミアは1症例に対して, 週1～2回の割合で, 合計2～10回おこなった.1回の治療時間は60分であり, 直腸温で温度計測をおこなった.温度上昇は1例を除いた9例において, 42℃以上が20～40分えられた.これらの治療効果をみると, 6例に肥大前立腺の縮小を認め, 自覚症状や尿流量測定による排尿障害の改善は9例に認めた.重篤な副作用はみられなかったが, 2例に皮下脂肪の硬結と, 1例に血精液を認めた.
以上よりこの治療は外来患者の前立腺肥大症に対して, 有用であると考えられた.

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再発性で多発性の膀胱癌11例に対して, hydroxypropylcellulose-doxorubicin (HPC-doxorubicin) の膀胱内注入に局所ハイパーサーミアを併用して治療した.
治療前のstageは, T1が4例, carcinoma in situが2例, T2が5例である.11例中7例に心疾患や肺気腫などの重篤な合併症がみられた.治療方法としては, まずHPC-doxorubicin 20mg/20mlをあらかじめ膀胱内に注入しておき, ついで8MHz-RF波による局所ハイパーサーミアをおこなった.治療結果は完全寛解 (complete response) が6例に, 部分寛解 (partial response) が4例に, 効果なし (no response) が1例であった.11例全例が現在まで生存している.その生存期間は8～45ヵ月である.この治療による副作用としては, 5例に皮下脂肪の硬結と2例に軽度の火傷を認めたのみで, 重篤なものはみられなかった.以上よりこの治療法は再発性膀胱癌に対して有用な治療法であると考えられた.

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