Effect Of Whole Body Hyperthermia On Preventing Radiation Pneumonia

Background：In China, Lung cancer has the highest incidence and mortality amongmalignant tumors and is still increasing rapidly. However, only20%-30%of thepatients after early detections can accept the surgical resection and approximately80%of the patients lose the opportunity to have curative resection, therefore, thecomprehensive treatment method which is based on radiotherapy and chemotherapybecomes the significant treatment for ad125vanced cancer.Radiotherapy can make lung tissue which close to tumor cause radiation-inducedlung injury of varying degrees for the reason that the radiation dose exceeds thresholdof biological effects, furthermore, it leads to death through heart and pulmonarycirculation failure.Radiation-induced lung injury is the most common complication for the patientsof common chest malignancies after receiving chest radiation therapy. And it becomesone of the most limiting factors of the radiation dose of the patients who accept thechest radiation therapy as it directly affects the efficacy of the patients.In recent years, it is gradually reported that whole body hyperthermia combinedwith radiotherapy and chemotherapy can improve the efficacy of advanced lungcancer. Whole body hyperthermia increase tumor cell killing, meanwhile it will notlead to more complication caused by radiotherapy, to some extent, it will reducecomplication caused by radiotherapy. Research purpose:Analyze clinical effects of whole body hyperthermia in the prevention ofradiation pneumonitisAnalyze the potential mechanism.Material and method:Select the initial treatment of97patients with stage Ⅲ-IV unresectable NSCLC,into radiotherapy and chemistry treatment combined with whole body hyperthermiagroup（HT+RT+CT） and radiotherapy and pharmaceutical chemistry treatment group（RT+CT）. There are49samples in group（HT+RT+CT），while47samples in group（RT+CT）．Both two groups accept6MV X ray external beam radiation therapy and wholebody chemotherapy, and the total radiation dose is60-66Gy/30-33times/6-6.5weeks.The whole-body chemotherapy is connected with synchronize chemotherapy andadjuvant chemotherapy．The synchronize chemotherapy begins in the first week, withDP regimen “Docetaxel75mg/m2d1+Cisplatin80mg/m2d1”，once every threeweeks； adjuvant chemotherapy begins after three weeks when radiotherapy isfinished，the regimen with the same synchronize chemotherapy, all2-cycle. While inHT+RT+CT group，whole body hyperthermia is carried out on the right day whenCisplatin chemotherapy is executed．Before heated rectum temperature measuring linemeasure the temperature, the remedy temperature is39.8-40.2℃．When it reaches theremedy temperature，infuse Cisplatin, and keep two hours in constant temperature．Respectively analyze the occurrence before radiation, during radiation, finishingradiation,3months after radiation of the radiation pneumonitis of the97patients.Result：To analyze the the cases of radiation pneumonitis that over grade2of the twogroups, the incidence rate of group（HT+RT+CT）accounted for5.40%while theincidence rate of group（RT+CT）accounted for20%.The incidence rate of group（HT+RT+CT）is Significantly lower than that of group（RT+CT）. The differencewas statistically significant(p<0.05)； Conclusion:1. Whole body hyperthermia have good clinical efficacy in prevention of radiationpneumonitis.2. Specific mechanisms of whole body hyperthermia in prevention of radiationpneumonitis still need further study.