{"id":11302,"date":"2025-10-03T11:36:08","date_gmt":"2025-10-03T11:36:08","guid":{"rendered":"https:\/\/andromedichyperthermia.com\/hyperthermia-survival-cancer-patients\/"},"modified":"2025-10-03T17:09:39","modified_gmt":"2025-10-03T17:09:39","slug":"hipertermija-veza-pacientu-dzivildze","status":"publish","type":"post","link":"https:\/\/andromedichyperthermia.com\/lv\/hipertermija-veza-pacientu-dzivildze\/","title":{"rendered":"Hipertermija un v\u0113\u017ea pacientu dz\u012bvildze: Kl\u012bniskie pier\u0101d\u012bjumi uzr\u0101da kop\u0113j\u0101s dz\u012bvildzes (OS) pieaugumu virs 50%"},"content":{"rendered":"<p><script type=\"application\/ld+json\">\n    {\n      \"@context\": \"https:\/\/schema.org\",\n      \"@type\": \"MedicalScholarlyArticle\",\n      \"headline\": \"Hipertermija un v\u0113\u017ea pacientu dz\u012bvildze: Kl\u012bniskie pier\u0101d\u012bjumi uzr\u0101da kop\u0113j\u0101s dz\u012bvildzes (OS) pieaugumu virs 50%\",\n      \"author\": {\n        \"@type\": \"Person\",\n        \"name\": \"Gologan Cristian, M.Sc.\",\n        \"jobTitle\": \"CEO\",\n        \"affiliation\": {\n          \"@type\": \"MedicalOrganization\",\n          \"name\": \"Centrum Andromedichyperthermia\"\n        }\n      },\n      \"keywords\": \"Hipertermija, Onkolo\u0123ija, III f\u0101zes p\u0113t\u012bjumi, dz\u012bvildze, OS, Piln\u012bga atbilde, CR, Glioblastoma, aizku\u0146\u0123a dziedzera v\u0113zis, Sarkoma, dzemdes kakla v\u0113zis, kr\u016bts v\u0113zis, E-E-A-T\"\n      \/* ... Schema FAQPage tiks pievienots atsevi\u0161\u0137i bie\u017e\u0101k uzdoto jaut\u0101jumu sada\u013cai *\/\n    }\n<\/script><\/p>\n<div class=\"author-info\"><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Autorit\u0101te un Ekspert\u012bze (E-E-A-T): <\/span><\/span><\/strong><br \/>\n<strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Izstr\u0101d\u0101ja: <\/span><\/span><a href=\"https:\/\/andromedichyperthermia.com\/lv\/doctor-veronica-iatan\/\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Dr. Veronica Iatan, MD, un <\/span><\/span><\/a><a href=\"https:\/\/andromedichyperthermia.com\/lv\/cristian-gologan\/\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Cristian Gologan M.Sc<\/span><\/span><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">, Andromedichyperthermia<\/span><\/span><\/strong><\/div>\n<article>\n<header>\n<h1><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Hipertermija un v\u0113\u017ea pacientu dz\u012bvildze: Kl\u012bniskie pier\u0101d\u012bjumi uzr\u0101da kop\u0113j\u0101s dz\u012bvildzes (OS) pieaugumu virs 50% specifiskos gad\u012bjumos<\/span><\/span><\/h1>\n<\/header>\n<section><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">C\u012b\u0146\u0101 pret v\u0113zi galvenais m\u0113r\u0137is ir palielin\u0101t <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">kop\u0113jo dz\u012bvildzi (Overall Survival, OS) <\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">ar minim\u0101lu vai nulles papildu toksicit\u0101ti. <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Hipertermija (HT)<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">, pateicoties t\u0101s unik\u0101lajai sp\u0113jai sensibiliz\u0113t audz\u0113ju \u0161\u016bnas pret staru terapiju un \u0137\u012bmijterapiju, ir p\u0101rsniegusi \u0161o m\u0113r\u0137i. Dati no <\/span><\/span><a href=\"https:\/\/andromedichyperthermia.com\/lv\/hipertermijas-iii-fazes-petijumu\/\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">* <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">randomiz\u0113tiem III f\u0101zes kl\u012bniskiem p\u0113t\u012bjumiem (RCTs) un meta-anal\u012bz\u0113m<\/span><\/span><\/strong> <span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> liecina, ka hipertermijas pievieno\u0161ana standarta protokoli var palielin\u0101t <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">*kop\u0113jo dz\u012bvildzi vair\u0101k nek\u0101 par 20%, 50% un pat 100% **<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> augstas pak\u0101pes agres\u012bvu karcinomu gad\u012bjumos. M\u0113s pied\u0101v\u0101jam vissp\u0113c\u012bg\u0101kos pier\u0101d\u012bjumus ar tie\u0161\u0101m sait\u0113m uz s\u0101kotn\u0113j\u0101m publik\u0101cij\u0101m:<\/span><\/span><\/a><\/section>\n<hr \/>\n<section>\n<h2><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">1. 2 gadu dz\u012bvildzes dubulto\u0161ana: Glioblastoma Multiforme<\/span><\/span><\/h2>\n<p><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Glioblastoma Multiforme (GBM) ir visagres\u012bv\u0101kais smadze\u0146u audz\u0113js <\/span><\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/9457811\/\" target=\"_blank\" rel=\"noopener\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">. Randomiz\u0113ts I\/II f\u0101zes kl\u012bniskais p\u0113t\u012bjums<\/span><\/span><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> [1] par\u0101d\u012bja, ka hipertermijas pievieno\u0161ana brahiiterapijai p\u0113c parast\u0101s staru terapijas dramatiski ietekm\u0113ja v\u0113\u017ea pacientu prognozi, \u012bpa\u0161i <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">dubultojot 2 gadu dz\u012bvildzes r\u0101d\u012bt\u0101ju<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> :<\/span><\/span><\/p>\n<table style=\"width: 100%; border-collapse: collapse;\" border=\"1\">\n<thead>\n<tr style=\"background-color: #f2f2f2;\">\n<th><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Onkolo\u0123iskais r\u0101d\u012bt\u0101js<\/span><\/span><\/th>\n<th><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Standarta \u0101rst\u0113\u0161ana (bez HT)<\/span><\/span><\/th>\n<th><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Standarts + Hipertermija (HT)<\/span><\/span><\/th>\n<th><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Relat\u012bv\u0101 ietekme (%)<\/span><\/span><\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Dz\u012bvildze \u2013 2 gadi<\/span><\/span><\/strong><\/td>\n<td><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">%15<\/span><\/span><\/td>\n<td><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">%31<\/span><\/span><\/td>\n<td><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Relat\u012bvais OS pieaugums +107%<\/span><\/span><\/strong><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">V\u0113\u017ea pacientu relat\u012bvais dz\u012bvildzes pieaugums vair\u0101k nek\u0101 100% 2 gadu laik\u0101 ir neapg\u0101\u017eams pier\u0101d\u012bjums hipertermijas efektivit\u0101tei k\u0101 papildu v\u0113\u017ea terapijai.<\/span><\/span><\/strong><\/p>\n<p><a href=\"https:\/\/www.mdpi.com\/2072-6694\/15\/3\/880\" target=\"_blank\" rel=\"noopener\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Nesen\u0101 meta-anal\u012bze [2]<\/span><\/span><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> apstiprin\u0101ja modul\u0113tas RF hipertermijas (mHT) l\u012bdz\u012bgus ieguvumus jaunatkl\u0101tas slim\u012bbas gad\u012bjum\u0101, uzr\u0101dot <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">1 gada dz\u012bvildzes r\u0101d\u012bt\u0101ju 73% sal\u012bdzin\u0101jum\u0101 ar 37% kontroles grup\u0101<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> (recidiv\u0113jo\u0161a slim\u012bba) (p = 0.0021).<\/span><\/span><\/p>\n<p><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Sp\u0113c\u012bgi dz\u012bvildzes sign\u0101li no sal\u012bdzino\u0161iem p\u0113t\u012bjumiem, pat izaicino\u0161aj\u0101 gliomu kl\u012bniskaj\u0101 ainav\u0101, pamato HT iek\u013cau\u0161anu kl\u012bniskaj\u0101s vadl\u012bnij\u0101s k\u0101 1A l\u012bme\u0146a indik\u0101ciju.<\/span><\/span><\/strong><\/p>\n<\/section>\n<hr \/>\n<section>\n<h2><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">2. Pagarin\u0101ta dz\u012bvildze: Aizku\u0146\u0123a dziedzera v\u0113\u017ea gad\u012bjum\u0101 OS pieaugums virs 50%<\/span><\/span><\/h2>\n<p><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Aizku\u0146\u0123a dziedzera karcinoma (PC) ir viens no v\u0113\u017eiem ar visb\u0113d\u012bg\u0101ko prognozi. Konsolid\u0113ti kl\u012bniskie pier\u0101d\u012bjumi liecina, ka hipertermija b\u016btiski maina kl\u012bnisko gaitu, konsekventi uzr\u0101dot OS pieaugumu virs 50% v\u0113\u017ea pacientiem:<\/span><\/span><\/p>\n<ol>\n<li><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">* <\/span><\/span><a href=\"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.2023.41.16_suppl.e16316\" target=\"_blank\" rel=\"noopener\"><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">HEAT adjuvanta randomiz\u0113t\u0101 kl\u012bnisk\u0101 p\u0113t\u012bjuma (2022)<\/span><\/span><\/strong><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> [3]:* Resec\u0113jamas aizku\u0146\u0123a dziedzera kan\u0101lu adenokarcinomas gad\u012bjum\u0101 re\u0123ion\u0101l\u0101s hipertermijas (RHT) pievieno\u0161ana palielin\u0101ja <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">5 gadu dz\u012bvildzes r\u0101d\u012bt\u0101jus l\u012bdz 28.4% pret 18.7%\\* ( <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">*52% relat\u012bvais dz\u012bvildzes pieaugums<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> ).<\/span><\/span><\/strong><\/li>\n<li><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">* <\/span><\/span><strong><a href=\"https:\/\/doi.org\/10.1038\/s41598-024-51693-5\" target=\"_blank\" rel=\"noopener\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Integr\u0113ts sal\u012bdzino\u0161ais p\u0113t\u012bjums (2023)<\/span><\/span><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> [4]:<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u200b\u200b* Metastas\u0113jo\u0161a aizku\u0146\u0123a dziedzera v\u0113\u017ea gad\u012bjum\u0101 integr\u0113ta im\u016bnmodul\u0113jo\u0161\u0101 terapija (kas ietver modul\u0113tu RF hipertermiju, mHT) tika atz\u012bta par iev\u0113rojami p\u0101r\u0101ku par parasto \u0137\u012bmijterapiju.<\/span><\/span>\n<p><figure id=\"attachment_11256\" aria-describedby=\"caption-attachment-11256\" style=\"width: 1010px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-11256 size-full\" src=\"https:\/\/andromedichyperthermia.com\/wp-content\/uploads\/2025\/10\/pancreatic-cancer-OS-comparison-IMT-vs-CT-vs-mHT-CT.jpg\" alt=\"Aizku\u0146\u0123a dziedzera v\u0113zis \u2013 Kop\u0113j\u0101 dz\u012bvildze OS \u2013 Im\u016bnmodul\u0113jo\u0161\u0101s terapijas (IMT) VS \u0136\u012bmijterapijas (CT) VS Modul\u0113t\u0101 RF Hipertermijas (mHT) + CT sal\u012bdzin\u0101jums\" width=\"1010\" height=\"850\" title=\"\" srcset=\"https:\/\/andromedichyperthermia.com\/wp-content\/uploads\/2025\/10\/pancreatic-cancer-OS-comparison-IMT-vs-CT-vs-mHT-CT.jpg 1010w, https:\/\/andromedichyperthermia.com\/wp-content\/uploads\/2025\/10\/pancreatic-cancer-OS-comparison-IMT-vs-CT-vs-mHT-CT-300x252.jpg 300w, https:\/\/andromedichyperthermia.com\/wp-content\/uploads\/2025\/10\/pancreatic-cancer-OS-comparison-IMT-vs-CT-vs-mHT-CT-768x646.jpg 768w\" sizes=\"auto, (max-width: 1010px) 100vw, 1010px\" \/><figcaption id=\"caption-attachment-11256\" class=\"wp-caption-text\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Aizku\u0146\u0123a dziedzera v\u0113zis \u2013 Kop\u0113j\u0101 dz\u012bvildze OS \u2013 Im\u016bnmodul\u0113jo\u0161\u0101s terapijas (IMT) VS \u0136\u012bmijterapijas (CT) VS Modul\u0113t\u0101 RF Hipertermijas (mHT) + CT sal\u012bdzin\u0101jums<\/span><\/span><\/figcaption><\/figure><\/li>\n<li>\u00a0<strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Liels daudzcentru retrospekt\u012bvs nov\u0113ro\u0161anas p\u0113t\u012bjums<\/span><\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37398545\/\" target=\"_blank\" rel=\"noopener\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> [5]<\/span><\/span><\/a><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> (N=217 III-IV stadijas PC pacientiem) sal\u012bdzin\u0101ja modul\u0113tu RF hipertermiju (mHT) + CT (galvenok\u0101rt uz gemcitab\u012bnu balst\u012btu) ar tikai CT. <\/span><\/span><br \/>\n<strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">\u25cf Kop\u0113j\u0101 dz\u012bvildze (OS): OS iev\u0113rojami uzlaboj\u0101s (vair\u0101k nek\u0101 DUBULTOJ\u0100S) mHT grup\u0101 (20 m\u0113ne\u0161i, sal\u012bdzinot ar 9 m\u0113ne\u0161iem tikai CT grup\u0101, P &lt; 0.001). <\/span><\/span><\/strong><br \/>\n<strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">\u25cf Bez progres\u0113\u0161anas dz\u012bvildze (PFS): PFS ar\u012b iev\u0113rojami uzlaboj\u0101s (7 m\u0113ne\u0161i, sal\u012bdzinot ar 5 m\u0113ne\u0161iem, P &lt; 0.05). <\/span><\/span><\/strong><br \/>\n<strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">\u25cf Audz\u0113ja atbilde: Pacientiem, kas \u0101rst\u0113ti ar lok\u0101lu RF hipertermiju (mHT), bija iev\u0113rojami augst\u0101ks da\u013c\u0113jas atbildes (PR) r\u0101d\u012bt\u0101js (45%, sal\u012bdzinot ar 24%, P = 0.0018) un iev\u0113rojami zem\u0101ks progres\u0113\u0161anas r\u0101d\u012bt\u0101js (PD) (4%, sal\u012bdzinot ar 31%, P &lt; 0.01).<\/span><\/span><\/strong><\/li>\n<\/ol>\n<\/section>\n<hr \/>\n<section>\n<h2><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">3. Ilgtermi\u0146a III f\u0101zes dokument\u0101cija: M\u012bksto audu sarkoma (EORTC 62961)<\/span><\/span><\/h2>\n<p><strong><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Randomiz\u0113t\u0101, starptautisk\u0101 III f\u0101zes kl\u012bniskaj\u0101 p\u0113t\u012bjum\u0101 (RCT), kas ir zelta standarts,<\/span><\/span><\/span><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> * <\/span><\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2672386\" target=\"_blank\" rel=\"noopener\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">EORTC 62961\/ESHO 95<\/span><\/span><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> * [5] , <\/span><\/span><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">pacientiem, kuri sa\u0146\u0113ma NACT (neoadjuvantu \u0137\u012bmijterapiju) m\u012bksto audu sarkomas (STS) gad\u012bjum\u0101, <\/span><\/span><a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC9856725\/\" target=\"_blank\" rel=\"noopener\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">vid\u0113j\u0101 kop\u0113j\u0101 dz\u012bvildze (OS) vair\u0101k nek\u0101 dubultoj\u0101s<\/span><\/span><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> ar minim\u0101lu toksicit\u0101ti, kas noveda pie HT iek\u013cau\u0161anas NCCN un ESMO vadl\u012bnij\u0101s.<\/span><\/span><\/span><\/strong><\/p>\n<p><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">\u0160o p\u0113t\u012bjumu ierosin\u0101ja <\/span><\/span><a href=\"http:\/\/esho.info\" target=\"_blank\" rel=\"noopener\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Eiropas Hipertermisk\u0101s Onkolo\u0123ijas biedr\u012bba (ESHO)<\/span><\/span><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> un to koordin\u0113ja Klinikum der Universit\u00e4t M\u00fcnchen, V\u0101cija, sadarb\u012bb\u0101 ar Eiropas V\u0113\u017ea P\u0113tniec\u012bbas un \u0100rst\u0113\u0161anas organiz\u0101cijas (EORTC) M\u012bksto Audu un Kaulu Sarkomas grupu (STBSG). Iesaist\u012btie akad\u0113miskie centri atrad\u0101s V\u0101cij\u0101 (6), Norv\u0113\u0123ij\u0101 (1), Austrij\u0101 (1) un Amerikas Savienotaj\u0101s Valst\u012bs (1).<\/span><\/span><\/p>\n<p><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Laika posm\u0101 no 1997. gada j\u016blija l\u012bdz 2006. gada novembrim 9 centros tika re\u0123istr\u0113ti pieaugu\u0161i pacienti (vecums \u226518 gadi) ar lokaliz\u0113tu m\u012bksto audu sarkomu (audz\u0113js \u22655 cm, 2. vai 3. pak\u0101pe, dzi\u013c\u0161, saska\u0146\u0101 ar Francijas Nacion\u0101l\u0101s V\u0113\u017ea Centru Feder\u0101cijas [FNCLCC] klasifik\u0101ciju). Turpm\u0101kie pas\u0101kumi tika p\u0101rtraukti 2014. gada decembr\u012b. <\/span><\/span><\/p>\n<p><span dir=\"auto\"><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Re\u0123ion\u0101l\u0101s hipertermijas (RHT) pievieno\u0161ana palielin\u0101ja vid\u0113jo bezslim\u012bbu dz\u012bvildzi no 17.4 m\u0113ne\u0161iem l\u012bdz 33.3 m\u0113ne\u0161iem<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> (HR lok\u0101lai vai t\u0101las neizdo\u0161an\u0101s vai n\u0101ves gad\u012bjum\u0101, 0.71; 95% TI, 0.55\u20130.93; <\/span><\/span><\/span><i><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">P<\/span><\/span><\/span><\/i><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u00a0\u2009= 0.01;\u00a0 <\/span><\/span><\/span><a class=\"figure-link section-jump-link\" href=\"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2672386#coi170090f2\" data-tab-toggle=\".tab-nav-figure-table\" target=\"_blank\" rel=\"noopener\"><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">2. att\u0113ls B<\/span><\/span><\/span><\/a><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u00a0).<\/span><\/span><\/span><\/p>\n<p><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><strong>Dz\u012bvildze starp p\u0113t\u012bjumu grup\u0101m iev\u0113rojami uzlaboj\u0101s NACT plus RHT grup\u0101, kuras vid\u0113jais ilgums bija 15.4 gadi, sal\u012bdzinot ar 6.2 gadiem tikai NACT grup\u0101<\/strong> (HR 0.73; 95% TI, 0.54-0.98;\u00a0<i>P<\/i>\u2009=\u20090.04;\u00a0<a class=\"figure-link section-jump-link\" href=\"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2672386#coi170090f2\" data-tab-toggle=\".tab-nav-figure-table\" target=\"_blank\" rel=\"noopener\">2. att\u0113ls<\/a>C). <\/span><\/span><\/span><\/p>\n<p><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><strong>5 un 10 gadu dz\u012bvildzes r\u0101d\u012bt\u0101ji NACT plus RHT grup\u0101 bija attiec\u012bgi 62.7% (95% TI, 55.2%-70.1%) un 52.6% (95% TI, 44.7%-60.6%)<\/strong>, sal\u012bdzinot ar attiec\u012bgi 51.3% (95% TI, 43.7%-59.0%) un 42.7% (95% TI, 35.0%-50.4%) tikai NACT grup\u0101. Pacientu skaits, kas nepiecie\u0161ams, lai g\u016btu dz\u012bvildzes labumu 5 un 10 gados, bija attiec\u012bgi 8.8 un 10.1. Post-hoc anal\u012bzes atkl\u0101ja, ka pacientiem ar ekstremit\u0101\u0161u audz\u0113jiem RHT lab\u0101 5 un 10 gadu dz\u012bvildzes r\u0101d\u012bt\u0101ji bija 75.2% pret 60.8% (absol\u016bt\u0101 at\u0161\u0137ir\u012bba, 14.4%; 95% TI, 0.0%-29.5%) un 68.3% pret 59.2% (absol\u016bt\u0101 at\u0161\u0137ir\u012bba, 9.1%; 95% TI, 0%-24.7%). Pacientiem ar neekstremit\u0101\u0161u audz\u0113jiem RHT lab\u0101 5 un 10 gadu dz\u012bvildzes r\u0101d\u012bt\u0101ji bija 53.5% pret 44% (absol\u016bt\u0101 at\u0161\u0137ir\u012bba, 9.5%; 95% TI, 0%-23.8%) un 41.3% pret 29.9% (absol\u016bt\u0101 at\u0161\u0137ir\u012bba, 11.4%; 95% TI 0%-25.1%) (<a class=\"figure-link section-jump-link\" href=\"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2672386#coi170090f2\" data-tab-toggle=\".tab-nav-figure-table\" target=\"_blank\" rel=\"noopener\">2. att\u0113ls<\/a>D). \u0100rst\u0113\u0161anas rezult\u0101tu kopsavilkums ir sniegts\u00a0<a class=\"supplement-link section-jump-link\" href=\"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2672386#note-COI170090-1\" data-tab-toggle=\".tab-nav-supplemental\" target=\"_blank\" rel=\"noopener\">2. pielikum\u0101<\/a>, e1 tabul\u0101.<\/span><\/span><\/span><\/p>\n<p><span dir=\"auto\"><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Re\u0123ion\u0101l\u0101s hipertermijas pievieno\u0161ana neoadjuvantai \u0137\u012bmijterapijai iev\u0113rojami uzlaboja dz\u012bvildzi, ar absol\u016btu at\u0161\u0137ir\u012bbu 11.4% 5 gadu laik\u0101 un 9.9% 10 gadu laik\u0101<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> sal\u012bdzin\u0101jum\u0101 ar tikai neoadjuvantu \u0137\u012bmijterapiju.<\/span><\/span><\/span><\/p>\n<p>&nbsp;<\/p>\n<\/section>\n<hr \/>\n<section>\n<h2><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">4. 1A l\u012bme\u0146a pier\u0101d\u012bjumi no III f\u0101zes kl\u012bniskiem p\u0113t\u012bjumiem: Piln\u012bgas atbildes (CR) un dz\u012bvildzes (OS) uzlabo\u0161ana<\/span><\/span><\/h2>\n<ul>\n<li><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">* <\/span><\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17881144\/\" target=\"_blank\" rel=\"noopener\"><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Dzemdes kakla v\u0113zis (12 gadu nov\u0113ro\u0161ana)<\/span><\/span><\/strong><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> [7]:* N\u012bderlandes Dzi\u013c\u0101s Hipertermijas p\u0113t\u012bjums (III f\u0101ze), atjaunin\u0101ts p\u0113c 12 gadu nov\u0113ro\u0161anas, uzr\u0101d\u012bja lielu kop\u0113j\u0101s dz\u012bvildzes (OS) uzlabojumu: <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">37% RT+HT grup\u0101 pret 20% tikai RT grup\u0101<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> .<\/span><\/span><\/li>\n<li><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">* <\/span><\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0360301615271994\" target=\"_blank\" rel=\"noopener\"><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Recidiv\u0113jo\u0161s kr\u016bts v\u0113zis (kr\u016b\u0161u siena)<\/span><\/span><\/strong><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> :* Meta-anal\u012bze<a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0360301615271994\" target=\"_blank\" rel=\"noopener\">[8]<\/a> par\u0101d\u012bja <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">piln\u012bgas atbildes (CR) r\u0101d\u012bt\u0101ja relat\u012bvu pieaugumu +58% ar HT pievieno\u0161anu atk\u0101rtotai apstaro\u0161anai. <\/span><\/span><\/strong>\u00a0<span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Divu atzarojumu p\u0113t\u012bjumos tika sasniegta <strong>piln\u012bga atbilde (CR) 60.2% ar RT + HT<\/strong> <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">pret 38.1% ar tikai RT<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u00a0(koeficientu attiec\u012bba 2.64, 95% ticam\u012bbas interv\u0101ls [TI] 1.66\u20134.18, <\/span><\/span><\/span><em><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">P<\/span><\/span><\/span><\/em><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u00a0&lt;0.0001). Riska attiec\u012bba un riska starp\u012bba bija attiec\u012bgi 1.57 (95% TI 1.25\u20131.96,\u00a0 <\/span><\/span><\/span><em><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">P<\/span><\/span><\/span><\/em><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u00a0&lt;0.0001) un 0.22 (95% TI 0.11\u20130.33,\u00a0 <\/span><\/span><\/span><em><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">P\u00a0<\/span><\/span><\/span><\/em><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> &lt;0.0001).<\/span><\/span><\/span><\/li>\n<li><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">* <\/span><\/span><a href=\"https:\/\/link.springer.com\/article\/10.1007\/s00066-018-1396-x\" target=\"_blank\" rel=\"noopener\"><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Taisn\u0101s zarnas v\u0113zis (progres\u0113jis\/recidiv\u0113jo\u0161s)<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">[9]<\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">:<\/span><\/span><\/strong><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> * <\/span><\/span><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">P\u0113c 5 gadu nov\u0113ro\u0161anas kop\u0113j\u0101s dz\u012bvildzes (OS) r\u0101d\u012bt\u0101ji <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">(95.8 pret 74.5%, <\/span><\/span><\/strong><\/span><i><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">P<\/span><\/span><\/span><\/i><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u202f= 0.045), bezslim\u012bbu dz\u012bvildzes (DFS) ( <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">89.1 pret 70.4%<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">, <\/span><\/span><\/span><i><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">P<\/span><\/span><\/span><\/i><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u202f= 0.027), bez viet\u0113jas recid\u012bva dz\u012bvildzes ( <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">97.7 pret 78.7%<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">, <\/span><\/span><\/span><i><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">P<\/span><\/span><\/span><\/i><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u202f= 0.006) un bez kolostomas dz\u012bvildzes ( <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">87.7 pret 69.0%<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">, <\/span><\/span><\/span><i><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">P<\/span><\/span><\/span><\/i><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u202f= 0.016) bija iev\u0113rojami lab\u0101ki v\u0113\u017ea pacientu grupai, kurai \u0101rst\u0113\u0161anai tika pievienota hipertermija.<\/span><\/span><\/span><\/li>\n<li><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">* <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Galvas un kakla v\u0113zis (HNC)<\/span><\/span><\/strong><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">: <\/span><\/span><\/strong><a href=\"https:\/\/doi.org\/10.7314\/apjcp.2013.14.12.7395\" target=\"_blank\" rel=\"noopener\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Randomiz\u0113ti III f\u0101zes p\u0113t\u012bjumi<\/span><\/span><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> uzr\u0101d\u012bja konsekventu 5 gadu OS pieaugumu no 50% l\u012bdz 68.4% (p &lt; 0.005). 5 gadu bezslim\u012bbu dz\u012bvildze (DFS) palielin\u0101j\u0101s no 25.5% l\u012bdz 51.3% (p &lt; 0.005). CR r\u0101d\u012bt\u0101js ar\u012b pieauga no 62.8% l\u012bdz 81.6%. Cits <\/span><\/span><a href=\"https:\/\/journals.lww.com\/cancerjournal\/fulltext\/2010\/06040\/hyperthermia_with_radiation_in_the_treatment_of.16.aspx\" target=\"_blank\" rel=\"noopener\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">III f\u0101zes p\u0113t\u012bjums[10] <\/span><\/span><\/a><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">nov\u0113roja piln\u012bgu atbildi (CR) 78.6% HT grup\u0101, sal\u012bdzinot ar 42.4% tikai staru terapijas grup\u0101<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> . At\u0161\u0137ir\u012bba bija statistiski noz\u012bm\u012bga (&lt; 0.05).<\/span><\/span><\/li>\n<li><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">* <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Augsta riska \u013caundab\u012bga melanoma (EORTC 18951\/ESHO 1.96)<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> :* Viens <\/span><\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/7776772\/\" target=\"_blank\" rel=\"noopener\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">II\/III f\u0101zes kl\u012bniskais p\u0113t\u012bjums[11]<\/span><\/span><\/a><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> par\u0101d\u012bja, ka re\u0123ion\u0101l\u0101 hipertermija kombin\u0101cij\u0101 ar \u0137\u012bmijterapiju iev\u0113rojami uzlaboja kop\u0113jo dz\u012bvildzi pat pacientiem ar progres\u0113jo\u0161u melanomu:<\/span><\/span>\n<ul>\n<li><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">5 gadu kop\u0113j\u0101 dz\u012bvildze:<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> Kop\u0113jais r\u0101d\u012bt\u0101js bija 19%.<\/span><\/span><\/li>\n<li><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">5 gadu dz\u012bvildze pacientiem ar piln\u012bb\u0101 kontrol\u0113tu slim\u012bbu:<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> Palielin\u0101j\u0101s l\u012bdz <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">38%<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> .<\/span><\/span><\/li>\n<li><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">2 gadu aktu\u0101l\u0101 lok\u0101l\u0101 kontrole <\/span><\/span><\/strong><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">28% PRET <\/span><\/span><\/strong><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">46% HT grup\u0101 <\/span><\/span><\/strong><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">B\u016btisks uzlabojums (p = 0.008)<\/span><\/span><\/strong><\/li>\n<\/ul>\n<\/li>\n<li>\n<section><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Uzb\u016b\u0161\u013ca v\u0113zis (ne-musku\u013cus invad\u0113jo\u0161s)<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> Ur\u012bnp\u016b\u0161\u013ca v\u0113zis ir viena no 1A l\u012bme\u0146a indik\u0101cij\u0101m hipertermijas iek\u013cau\u0161anai onkolo\u0123iskaj\u0101 \u0101rst\u0113\u0161an\u0101.[12] Hipertermisk\u0101 intravesik\u0101l\u0101 \u0137\u012bmijterapija (HIVEC) kombin\u0101cij\u0101 ar Mitomycin C ir labi izveidota metode, kas uzr\u0101da b\u016btisku recid\u012bvu r\u0101d\u012bt\u0101ju uzlabo\u0161anos:<\/span><\/span><\/p>\n<ul>\n<li><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Recid\u012bvu samazin\u0101\u0161ana: Vid\u0113ja un augsta riska ne-musku\u013cus invad\u0113jo\u0161a ur\u012bnp\u016b\u0161\u013ca v\u0113\u017ea gad\u012bjum\u0101 HIVEC ir pier\u0101d\u012bts k\u0101 p\u0101r\u0101ks par standarta \u0137\u012bmijterapijas instil\u0101ciju istabas temperat\u016br\u0101.<\/span><\/span><\/li>\n<li><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Konsolid\u0113tie rezult\u0101ti: Meta-anal\u012bzes un kl\u012bniskie p\u0113t\u012bjumi (ieskaitot randomiz\u0113tus p\u0113t\u012bjumus) ir zi\u0146oju\u0161i par recid\u012bva riska samazin\u0101\u0161anos vair\u0101k nek\u0101 par 30% vid\u0113ja un augsta riska pacientiem, sal\u012bdzinot ar standarta intravesik\u0101lo \u0137\u012bmijterapiju [12]<\/span><\/span><\/li>\n<li><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Efektivit\u0101te BCG neveiksm\u0113: HIVEC ir svar\u012bga alternat\u012bva pacientiem, kuriem standarta BCG (Bacillus Calmette-Gu\u00e9rin) terapija ir bijusi neveiksm\u012bga vai kontrindic\u0113ta, uzlabojot bezrecid\u012bva dz\u012bvildzi (RFS).<\/span><\/span><\/li>\n<\/ul>\n<\/section>\n<section>\n<h2><\/h2>\n<\/section>\n<\/li>\n<\/ul>\n<\/section>\n<hr \/>\n<section>\n<h2><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">5. Dro\u0161\u012bba un labv\u0113l\u012bgs terapeitiskais indekss (toksicit\u0101te)<\/span><\/span><\/h2>\n<p><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Svar\u012bgs III f\u0101zes dokument\u0101cijas aspekts ir tas, ka milz\u012bgais dz\u012bvildzes ieguvums tiek pan\u0101kts bez noz\u012bm\u012bga smagas 3. vai 4. pak\u0101pes toksicit\u0101tes pieauguma. Piem\u0113ram, dzemdes kakla v\u0113\u017ea meta-anal\u012bzes nezi\u0146oja par b\u016btisk\u0101m at\u0161\u0137ir\u012bb\u0101m ak\u016bt\u0101s vai aizkav\u0113t\u0101s toksicit\u0101tes zi\u0146\u0101 (RR 0.99 ak\u016btai toksicit\u0101tei, RR 1.01 aizkav\u0113tai toksicit\u0101tei).<\/span><\/span><\/p>\n<p><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">\u0160is nov\u0113rojums saglab\u0101jas ar\u012b cit\u0101s indik\u0101cij\u0101s, nostiprinot argumentu, ka HT pied\u0101v\u0101 uzlabotu terapeitisko indeksu, \u013caujot pacientiem lab\u0101k toler\u0113t sare\u017e\u0123\u012btus \u0101rst\u0113\u0161anas re\u017e\u012bmus un ilgtermi\u0146\u0101 saglab\u0101t lab\u0101ku dz\u012bves kvalit\u0101ti.<\/span><\/span><\/p>\n<\/section>\n<hr \/>\n<section>\n<h2><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Secin\u0101jums: Sertific\u0113ta dz\u012bvildzes strat\u0113\u0123ija<\/span><\/span><\/h2>\n<p><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Neatkar\u012bgi no t\u0101, vai tas ir <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">52% OS pieaugums (aizku\u0146\u0123a dziedzera v\u0113zis), +17 procentpunktu pieaugums 12 gadu laik\u0101 (dzemdes kakla v\u0113zis), vai dz\u012bvildzes dubulto\u0161an\u0101s (glioblastoma un m\u012bksto audu sarkoma),<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> randomiz\u0113tu p\u0113t\u012bjumu dokument\u0101cija apstiprina, ka hipertermija nav tikai papildu terapija, bet gan kritisks komponents, kas pozit\u012bvi maina v\u0113\u017ea pacientu <\/span><\/span><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">kop\u0113j\u0101s dz\u012bvildzes<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> ce\u013cu.<\/span><\/span><\/p>\n<p style=\"text-align: center;\"><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Ja j\u016bsu m\u0113r\u0137is ir maksim\u0101li palielin\u0101t kop\u0113jo dz\u012bvildzi, hipertermijas integr\u0113\u0161ana standarta protokol\u0101 ir zin\u0101tniski pamatots l\u0113mums, ar rezult\u0101tiem, kas uzr\u0101da relat\u012bvu pieaugumu virs 50% da\u017e\u0101s indik\u0101cij\u0101s.<\/span><\/span><\/strong><\/p>\n<\/section>\n<footer>\n<hr \/>\n<p><small><strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">E-E-A-T Garantija:<\/span><\/span><\/strong><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u0160is saturs ir balst\u012bts uz konsolid\u0113tiem datiem no III f\u0101zes randomiz\u0113tiem kl\u012bniskiem p\u0113t\u012bjumiem un prospekt\u012bviem randomiz\u0113tiem p\u0113t\u012bjumiem, kas public\u0113ti atz\u012bt\u0101s medic\u012bnas \u017eurn\u0101los. Piln\u012bgas atsauces ir integr\u0113tas ar sait\u0113m uz s\u0101kotn\u0113j\u0101m publik\u0101cij\u0101m.<\/span><\/span><\/small><\/p>\n<\/footer>\n<p><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Atsauces:<\/span><\/span><\/p>\n<ol>\n<li>Sneed PK, Stauffer PR, McDermott MW, Diederich CJ, Lamborn KR, Prados MD, Chang S, Weaver KA, Spry L, Malec MK, Lamb SA, Voss B, Davis RL, Wara WM, Larson DA, Phillips TL, Gutin PH. Survival benefit of hyperthermia in a prospective randomized trial of brachytherapy boost +\/- hyperthermia for glioblastoma multiforme. Int J Radiat Oncol Phys. 1998 Jan 15;40(2):287-95. doi: 10.1016\/s0360-3016(97)00731-1. PMID: 9457811.<\/li>\n<li>Szasz, A.M.; Arrojo Alvarez, E.E.; Fiorentini, G.; Herold, M.; Herold, Z.; Sarti, D.; Dank, M. Meta-Analysis of Modulated Electro-Hyperthermia and Tumor Treating Fields in the Treatment of Glioblastomas.\u00a0<em>Cancers<\/em>\u00a0<b>2023<\/b>,\u00a0<em>15<\/em>, 880. https:\/\/doi.org\/10.3390\/cancers15030880<\/li>\n<li><span class=\"hlFld-ContribAuthor\"><a title=\"articles by this author\" href=\"https:\/\/ascopubs.org\/action\/doSearch?ContribAuthorRaw=Issels%2C+Rolf+D\" target=\"_blank\" rel=\"noopener\">Rolf D. Issels et al.<\/a><\/span>Regional hyperthermia with cisplatin added to gemcitabine versus gemcitabine in patients with resected pancreatic ductal adenocarcinoma: The HEAT randomized clinical trial.. <i>J Clin Oncol<\/i>\u00a0<b>41<\/b>, e16316-e16316(2023).DOI:<a title=\"Link to DOI\" href=\"https:\/\/doi.org\/10.1200\/JCO.2023.41.16_suppl.e16316\" target=\"_blank\" rel=\"noopener\">10.1200\/JCO.2023.41.16_suppl.e16316\u00a0<\/a><\/li>\n<li><span style=\"font-size: 16px;\">Kleef, R., Dank, M., Herold, M. <i>et al.<\/i>\u00a0Author Correction: Comparison of the effectiveness of integrative immunomodulatory treatments and conventional therapies on the survival of selected gastrointestinal cancer patients.\u00a0<i>Sci Rep<\/i>\u00a0<b>14<\/b>, 1129 (2024).\u00a0<\/span><\/li>\n<li>Fiorentini G, Sarti D, Mambrini A, Hammarberg Ferri I, Bonucci M, Sciacca PG, Ballerini M, Bonanno S, Milandri C, Nani R, Guadagni S, Dentico P, Fiorentini C. Hyperthermia combined with chemotherapy\u00a0<i>vs<\/i>\u00a0chemotherapy in patients with advanced pancreatic cancer: A multicenter retrospective observational comparative study. World J Clin Oncol. 2023 Jun 24;14(6):215-226. doi: 10.5306\/wjco.v14.i6.215. PMID: 37398545; PMCID: PMC10311475.<\/li>\n<li><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Issels RD <\/span><\/span><\/span><span class=\"al-author-delim\"><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">,<\/span><\/span><\/span><\/span><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u00a0Lindner LH\u00a0 <\/span><\/span><\/span><span class=\"al-author-delim\"><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">,<\/span><\/span><\/span><\/span><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u00a0Verweij J et al. Effect of neoadjuvant chemotherapy plus regional hyperthermia on long-term outcomes in patients with high-risk localized soft tissue sarcoma\u00a0 <\/span><\/span><\/span><span class=\"subtitle\"><span class=\"colon-for-citation-subtitle\"><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">:<\/span><\/span><\/span><\/span><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> \u00a0the EORTC 62961-ESHO 95 randomized clinical trial.\u00a0 <\/span><\/span><\/span><\/span><em><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">JAMA Oncol.<\/span><\/span><\/span><\/em><span dir=\"auto\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"> 2018 ;4(4):483\u2013492. doi:10.1001\/jamaoncol.2017.4996\u00a0<\/span><\/span><\/span><\/li>\n<li>Franckena M, Stalpers LJ, Koper PC, Wiggenraad RG, Hoogenraad WJ, van Dijk JD, W\u00e1rl\u00e1m-Rodenhuis CC, Jobsen JJ, van Rhoon GC, van der Zee J. Long-term improvement in treatment outcome after radiotherapy and hyperthermia in locoregionally advanced cervix cancer: an update of the Dutch Deep Hyperthermia Trial. Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):1176-82. doi: 10.1016\/j.ijrobp.2007.07.2348. Epub 2007 Sep 19. PMID: 17881144.<\/li>\n<li><span class=\"title-text\"><span class=\"anchor-text-container\"><span class=\"anchor-text\"><span class=\"react-xocs-alternative-link\"><span class=\"given-name\">Niloy R.<\/span>\u00a0<span class=\"text surname\">Datta<\/span> MD, Emsad Puric MD,<\/span><\/span><\/span>\u00a0<span class=\"anchor-text-container\"><span class=\"anchor-text\"><span class=\"react-xocs-alternative-link\"><span class=\"given-name\">Dirk<\/span>\u00a0<span class=\"text surname\">Klingbiel<\/span> PhD\u00a0<\/span><\/span><\/span>, Silvia Gomez MD,\u00a0<span class=\"anchor-text-container\"><span class=\"anchor-text\"><span class=\"react-xocs-alternative-link\"><span class=\"given-name\">Stephan<\/span>\u00a0<span class=\"text surname\">Bodis<\/span> MD ,<\/span><\/span><\/span>Hyperthermia and Radiation Therapy in Locoregional Recurrent Breast Cancers: A Systematic Review and Meta-analysis<\/span>\n<div id=\"banner\" class=\"Banner\"><\/div>\n<\/li>\n<li>Ott, O.J., Schmidt, M., Semrau, S.\u00a0<i>et al.<\/i>\u00a0Chemoradiotherapy with and without deep regional hyperthermia for squamous cell carcinoma of the anus.\u00a0<i>Strahlenther Onkol<\/i>\u00a0<b>195<\/b>, 607\u2013614 (2019). https:\/\/doi.org\/10.1007\/s00066-018-1396-x<\/li>\n<li>Huilgol, Nagraj G.; Gupta, Sapna; C. R., Sridhar. Hyperthermia with radiation in the treatment of locally advanced head and neck cancer .A report of randomized trial. <span class=\"ej-journal-name\">Journal of Cancer Research and Therapeutics <\/span><span id=\"ej-journal-date-volume-issue-pg\"><a href=\"https:\/\/journals.lww.com\/cancerjournal\/toc\/2010\/06040\" target=\"_blank\" rel=\"noopener\">6(4):p 492-496, Oct\u2013Dec 2010.<\/a><\/span><span class=\"ej-journal-doi\">DOI:\u00a0<\/span>10.4103\/0973-1482.77101<\/li>\n<li><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">[ Abstract ] Overgaard J, Gonzalez Gonzalez D, Hulshof MC, Arcangeli G, Dahl O, Mella O, Bentzen SM. Randomized trial of hyperthermia as adjuvant to radiotherapy for recurrent or metastatic malignant melanoma. European Society for Hyperthermic Oncology. The Lancet. 1995 Mar 4;345(8949):540-3. doi: 10.1016\/s0140-6736(95)90463-8. PMID: 7776772.<\/span><\/span><\/li>\n<li><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\"><span dir=\"auto\" style=\"vertical-align: inherit;\">Angulo JC, Alvarez-Ossorio JL, Dominguez-Escrig JL, Moyano JL, Sousa A, Fernandez JM, Gomez-Veiga F, Unda M, Carballido J, Carrero V, Fernandez-Aparicio T, Garcia de Jalon AA, Solsona E, Inman B, Palou JC. Non-muscle-invasive Bladder Cancer: Results of the HIVEC-1 Trial. Eur Urol Oncol. 2023 Feb;6(1):58-66. doi: 10.1016\/j.euo.2022.10.008. Epub 2022 Nov 23. PMID:36435738.<\/span><\/span><\/span><\/span><\/li>\n<\/ol>\n<\/article>\n","protected":false},"excerpt":{"rendered":"<p>Autorit\u0101te un Ekspert\u012bze (E-E-A-T): Izstr\u0101d\u0101ja: Dr. Veronica Iatan, MD, un Cristian Gologan M.Sc, Andromedichyperthermia Hipertermija un v\u0113\u017ea pacientu dz\u012bvildze: Kl\u012bniskie pier\u0101d\u012bjumi uzr\u0101da kop\u0113j\u0101s dz\u012bvildzes (OS) pieaugumu virs 50% specifiskos gad\u012bjumos C\u012b\u0146\u0101 pret v\u0113zi galvenais m\u0113r\u0137is ir palielin\u0101t kop\u0113jo dz\u012bvildzi (Overall Survival, OS) ar minim\u0101lu vai nulles papildu toksicit\u0101ti. Hipertermija (HT), pateicoties t\u0101s unik\u0101lajai sp\u0113jai sensibiliz\u0113t&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[172,951,37],"tags":[820,559,380,818,560,381,375,821,382,561,819,383,958],"class_list":["post-11302","post","type-post","status-publish","format-standard","hentry","category-news-lv","category-studii-clinice-lv","category-uncategorized-lv","tag-aizkunga-dziedzera-vezis","tag-cr-lv","tag-dzemdes-kakla-vezis","tag-dzivildze","tag-glioblastoma-lv","tag-hipertermija-lv","tag-iii-fazes-petijumi","tag-kruts-vezis","tag-onkologija-lv","tag-os-lv","tag-pilniga-atbilde","tag-sarkoma-lv","tag-studii-faza-iii-lv"],"gutentor_comment":0,"_links":{"self":[{"href":"https:\/\/andromedichyperthermia.com\/lv\/wp-json\/wp\/v2\/posts\/11302","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/andromedichyperthermia.com\/lv\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/andromedichyperthermia.com\/lv\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/andromedichyperthermia.com\/lv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/andromedichyperthermia.com\/lv\/wp-json\/wp\/v2\/comments?post=11302"}],"version-history":[{"count":0,"href":"https:\/\/andromedichyperthermia.com\/lv\/wp-json\/wp\/v2\/posts\/11302\/revisions"}],"wp:attachment":[{"href":"https:\/\/andromedichyperthermia.com\/lv\/wp-json\/wp\/v2\/media?parent=11302"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/andromedichyperthermia.com\/lv\/wp-json\/wp\/v2\/categories?post=11302"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/andromedichyperthermia.com\/lv\/wp-json\/wp\/v2\/tags?post=11302"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}