A novel strategy of radiofrequency hyperthermia (neothermia) in combination with preoperative chemoradiotherapy for the treatment of advanced rectal cancer: a pilot study

Cancer Medicine

Hisanori Shoji²  Masahiko Motegi²  Kiyotaka Osawa²  Noriyuki Okonogi¹  Atsushi Okazaki¹  Yoshitaka Andou²  Takayuki Asao³  Hiroyuki Kuwano⁴  Takeo Takahashi⁵ 

[1] Division of Radiology, Hidaka Hospital, Gunma, Japan;Division of Surgery, Hidaka Hospital, Gunma, Japan;Department of Oncology Clinical Development, Graduate School of Medicine, Gunma University, Gunma, Japan;Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma, Japan;Department of Radiation Oncology, Saitama Medical Center, Saitama Medical University, Saitama, Japan

关键词: 8 MHz radiofrequency capacitive heating device;    capecitabine;    hyperthermia;    intensity‐modulated radiotherapy;    rectal cancer;    reference point;   

DOI  :  10.1002/cam4.431

来源: Wiley

【 摘 要 】

Abstract

The safety of weekly regional hyperthermia performed with 8 MHz radiofrequency (RF) capacitive heating equipment has been established in rectal cancer. We aimed to standardize hyperthermia treatment for scientific evaluation and for assessing local tumor response to RF hyperthermia in rectal cancer. Forty-nine patients diagnosed with rectal adenocarcinoma were included in the study. All patients received chemoradiation with intensity-modulated radiation therapy 5 days/week (dose, 50 Gy/25 times) concomitant with 5 days/week for five times of capecitabine (1700 mg/m² per day) and once a week for five times of 50 min irradiations by an 8 MHz RF capacitive heating device. Thirty-three patients underwent surgery 8 weeks after treatment. Three patients did not undergo surgery because of progressive disease (PD) and 13 refused. Eight (16.3%) patients had a pathological complete response (ypCR) after surgery. Among patients without surgery, 3 (6.1%) had clinical complete response (CR) and 3 (6.1%) had local CR but distant PD (CRPD). Ninety percent of ypCR + CR patients were shown in 6.21 W min⁻¹ m⁻²/treatment or higher group of average total accumulated irradiation output with 429°C min⁻¹ m⁻² or higher group of total accumulated thermal output. However, a patient with CRPD was in the higher total accumulated thermal output group. We propose a new quantitative parameter for the hyperthermia and demonstrated that patients can benefit from mild irradiation with mild temperature. Using these parameters, the exact output, optimal thermal treatment, and contraindications or indications of this modality could be determined in a multi-institutional, future study.

【 授权许可】

CC BY   
© 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.