{"id":2749,"date":"2017-08-12T11:01:57","date_gmt":"2017-08-12T11:01:57","guid":{"rendered":"https:\/\/andromedichyperthermia.com\/2017\/08\/12\/proveditelnost-lecby-hlubokou-lokalni-hypertermii-ve-spojeni-se-standardni-lecbou-rakoviny-a-vzorce-odpovedi-esho\/"},"modified":"2025-09-01T16:55:26","modified_gmt":"2025-09-01T16:55:26","slug":"klinicka-studie-hluboka-hypertermie","status":"publish","type":"post","link":"https:\/\/andromedichyperthermia.com\/cs\/klinicka-studie-hluboka-hypertermie\/","title":{"rendered":"Hlubok\u00e1 region\u00e1ln\u00ed hypertermie v kombinaci s radioterapi\u00ed cel\u00e9ho mozku (WBRT) u pacient\u016f s mozkov\u00fdmi metast\u00e1zami se \u0161patnou progn\u00f3zou"},"content":{"rendered":"

Hlubok\u00e1 region\u00e1ln\u00ed hypertermie v kombinaci s radioterapi\u00ed cel\u00e9ho mozku (WBRT) u pacient\u016f s mozkov\u00fdmi metast\u00e1zami se \u0161patnou progn\u00f3zou<\/span><\/span><\/a><\/h1>\n

\u00a0Klinick\u00e1 studie – hypertermie<\/mark><\/h2>\n

<\/h1>\n
\"Klinick\u00e1
Hlubok\u00e1 lok\u00e1ln\u00ed hypertermie v kombinaci s radioterapi\u00ed cel\u00e9ho mozku (WBRT) u pacient\u016f s mozkov\u00fdmi metast\u00e1zami a \u0161patnou progn\u00f3zou<\/span><\/span><\/figcaption><\/figure>\n

Abstrakt<\/span><\/strong> klinick\u00e9 studie<\/span><\/span><\/h2>\n

\u00da\u010del:<\/span><\/span><\/strong> C\u00edlem t\u00e9to klinick\u00e9 studie je poprv\u00e9 posoudit roli region\u00e1ln\u00ed hlubok\u00e9 hypertermie v kombinaci s radioterapi\u00ed a syst\u00e9movou terapi\u00ed u pacient\u016f se \u0161patnou progn\u00f3zou mozkov\u00fdch metast\u00e1z (GPI \u2264 2,5).<\/span><\/span><\/p>\n

Metody:<\/span><\/span><\/strong> Do t\u00e9to prospektivn\u00ed studie byli za\u0159azeni pacienti s potvrzen\u00fdmi mozkov\u00fdmi metast\u00e1zami a klasifikovan\u00fdmi jako GPI sk\u00f3re \u2264 2,5. Stratifikace p\u0159ed l\u00e9\u010dbou byla definov\u00e1na jako pacienti s GPI sk\u00f3re 0-1 (skupina A) a pacienti s GPI sk\u00f3re 1,5-2,5 (skupina B). HT byla aplikov\u00e1na dvakr\u00e1t t\u00fddn\u011b, \u0161edes\u00e1t minut na sezen\u00ed, b\u011bhem RT pomoc\u00ed region\u00e1ln\u00edho kapacitn\u00edho za\u0159\u00edzen\u00ed ( <\/span>hypertermick\u00fd p\u0159\u00edstroj <\/span><\/a><\/span>Andromedic<\/span><\/span><\/a> HyDeep 600WM ) o radiofrekvenci 13,56 MHz.<\/span><\/span><\/p>\n

V\u00fdsledky:<\/span><\/span><\/strong> Mezi \u010dervnem 2015 a \u010dervnem 2017 bylo do protokolu zahrnuto 15 pacient\u016f s celkem 49 mozkov\u00fdmi metast\u00e1zami. V\u0161ichni pacienti absolvovali v\u0161echna sezen\u00ed HT dle pl\u00e1nu. Radioterapie a syst\u00e9mov\u00e1 terapie byly tak\u00e9 dokon\u010deny dle p\u0159edepsan\u00e9ho postupu. <\/span><\/span>Tolerance l\u00e9\u010dby byla vynikaj\u00edc\u00ed a nebyla zaznamen\u00e1na \u017e\u00e1dn\u00e1 toxicita. Pacienti s dobou efektivn\u00ed l\u00e9\u010dby HT del\u0161\u00ed ne\u017e medi\u00e1n (W90time>88 %) vykazovali lep\u0161\u00ed aktu\u00e1rn\u00ed PFS po 6 a 12 m\u011bs\u00edc\u00edch (100 % a 66,7 %) ve srovn\u00e1n\u00ed s pacienty s krat\u0161\u00ed dobou efektivn\u00ed l\u00e9\u010dby HT (50 % a 0 %)<\/span><\/span><\/strong> (p<0,031). Medi\u00e1n celkov\u00e9ho p\u0159e\u017eit\u00ed (OS) byl 6 m\u011bs\u00edc\u016f (rozmez\u00ed 1\u201336 m\u011bs\u00edc\u016f). Stratifikace podle sk\u00f3re GPI uk\u00e1zala medi\u00e1n OS 3 m\u011bs\u00edce (CI 95 % 2,49\u20133,51) ve skupin\u011b A a 8,0 m\u011bs\u00edc\u016f (CI 95 % 5,15\u201310,41) ve skupin\u011b B (p=0,035).<\/span><\/span><\/p>\n

Z\u00e1v\u011bry: <\/span><\/span><\/strong> Region\u00e1ln\u00ed hypertermie je provediteln\u00e1 a bezpe\u010dn\u00e1 technika pro pou\u017eit\u00ed v kombinaci s radioterapi\u00ed u pacient\u016f s mozkov\u00fdmi metast\u00e1zami, kter\u00e1 zlep\u0161uje PFS a p\u0159e\u017eit\u00ed u pacient\u016f s mozkov\u00fdmi metast\u00e1zami se \u0161patnou progn\u00f3zou.<\/span><\/span><\/strong><\/p>\n

 <\/p>\n

Do na\u0161\u00ed studie bylo zahrnuto 49 mozkov\u00fdch metast\u00e1z od 15 pacient\u016f, kte\u0159\u00ed pat\u0159\u00ed do nejnep\u0159\u00edzniv\u011bj\u0161\u00edch skupin GPA: 6 pacient\u016f m\u011blo sk\u00f3re index 0-1 (skupina A) a 9 pacient\u016f m\u011blo sk\u00f3re index 1,5-2,5 (skupina B). V\u0161ichni pacienti byli l\u00e9\u010deni kombinac\u00ed radioterapie a region\u00e1ln\u00ed HT. Prvn\u00edm z\u00e1v\u011brem na\u0161\u00ed studie je, \u017ee kombinovan\u00e1 radioterapie a region\u00e1ln\u00ed HT je u pacient\u016f s mozkov\u00fdmi metast\u00e1zami dob\u0159e tolerovan\u00e1 l\u00e9\u010dba. V\u0161echny l\u00e9\u010debn\u00e9 postupy byly pod\u00e1v\u00e1ny dle p\u0159edpisu <\/span><\/span>.<\/span><\/span><\/strong><\/p>\n

Nebyla zaznamen\u00e1na \u017e\u00e1dn\u00e1 toxicita v d\u016fsledku HT. Naproti tomu Byun a kol. [13] ve sv\u00e9 studii s intraopera\u010dn\u00ed HT popsali z\u00e1chvaty a infekci r\u00e1ny jako komplikace kombinovan\u00e9 l\u00e9\u010dby v relevantn\u00edm po\u010dtu p\u0159\u00edpad\u016f. <\/span><\/span><\/strong> Hlubok\u00e1 hypertermie se zd\u00e1 b\u00fdt snadn\u011bji a bezpe\u010dn\u011bj\u0161\u00ed ne\u017e komplikovan\u00e1 intraopera\u010dn\u00ed l\u00e9\u010dba<\/span><\/span><\/strong> .<\/span><\/span><\/p>\n

Kvalita l\u00e9\u010dby HT (W90time >88 %) vedla k nejsiln\u011bj\u0161\u00edmu prediktivn\u00edmu faktoru pro p\u0159e\u017eit\u00ed. Pacienti, kte\u0159\u00ed dost\u00e1vali >88 % doby l\u00e9\u010dby p\u0159i 90 % p\u0159edepsan\u00e9ho v\u00fdkonu (150 W), m\u011bli tedy vynikaj\u00edc\u00ed m\u00edru PFS, co\u017e potvrzuje roli HT v senzibilizaci n\u00e1dor\u016f k radiochemoterapii [4-7].<\/span><\/span><\/p>\n

Podle celkov\u00e9ho p\u0159e\u017eit\u00ed byl medi\u00e1n celkov\u00e9ho p\u0159e\u017eit\u00ed v na\u0161\u00ed s\u00e9rii 6 m\u011bs\u00edc\u016f, co\u017e zlep\u0161ilo \u0161patn\u00e9 v\u00fdsledky standardn\u00ed l\u00e9\u010dby v t\u011bchto p\u0159\u00edpadech [3]. Spojen\u00ed hypertermie s radioterapi\u00ed +\/- syst\u00e9movou l\u00e9\u010dbou dos\u00e1hlo u na\u0161ich pacient\u016f s metast\u00e1zami v mozku pravd\u011bpodobnosti p\u0159e\u017eit\u00ed 53,1 % a 30,6 % po 12 m\u011bs\u00edc\u00edch<\/span><\/span><\/strong> .<\/span><\/span><\/p>\n

https:\/\/pubmed.ncbi.nlm.nih.gov\/32748093\/<\/span><\/span><\/p>\n

https:\/\/link.springer.com\/article\/10.1007\/s12094-020-02404-9<\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Hlubok\u00e1 region\u00e1ln\u00ed hypertermie v kombinaci s radioterapi\u00ed cel\u00e9ho mozku (WBRT) u pacient\u016f s mozkov\u00fdmi metast\u00e1zami se \u0161patnou progn\u00f3zou \u00a0Klinick\u00e1 studie – hypertermie Abstrakt klinick\u00e9 studie \u00da\u010del: C\u00edlem t\u00e9to klinick\u00e9 studie je poprv\u00e9 posoudit roli region\u00e1ln\u00ed hlubok\u00e9 hypertermie v kombinaci s radioterapi\u00ed a syst\u00e9movou terapi\u00ed u pacient\u016f se \u0161patnou progn\u00f3zou mozkov\u00fdch metast\u00e1z (GPI \u2264 2,5). Metody:…<\/p>\n","protected":false},"author":1,"featured_media":7037,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[111],"tags":[],"class_list":["post-2749","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"gutentor_comment":0,"_links":{"self":[{"href":"https:\/\/andromedichyperthermia.com\/cs\/wp-json\/wp\/v2\/posts\/2749","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/andromedichyperthermia.com\/cs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/andromedichyperthermia.com\/cs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/andromedichyperthermia.com\/cs\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/andromedichyperthermia.com\/cs\/wp-json\/wp\/v2\/comments?post=2749"}],"version-history":[{"count":0,"href":"https:\/\/andromedichyperthermia.com\/cs\/wp-json\/wp\/v2\/posts\/2749\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/andromedichyperthermia.com\/cs\/wp-json\/wp\/v2\/media\/7037"}],"wp:attachment":[{"href":"https:\/\/andromedichyperthermia.com\/cs\/wp-json\/wp\/v2\/media?parent=2749"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/andromedichyperthermia.com\/cs\/wp-json\/wp\/v2\/categories?post=2749"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/andromedichyperthermia.com\/cs\/wp-json\/wp\/v2\/tags?post=2749"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}