Early report of correlation between the thermal dosage and the treatment effect of hyperthermia in combination with chemoradiotherapy for esophageal cancer patients.
OBJECTIVE
It is known to be difficult to determine thermal dosage in clinical tumor treatment. The aim of this study is to examine whether the quantitative heating dose reflects the treatment effect in esophageal cancer.


METHODS
Hyperthermo-chemoradiotherapy was performed on 14 patients with advanced esophageal cancer. The heating dosage was calculated as an integration of the isoeffective dose at 43 degrees C using the following formulas: delta teq(T) = 2(T-43).delta t (second)--(a) (> or = 42.5 degrees C) delta teq(T) = 2(42.5-43).6(T-42.5).delta t (second)--(b) (< 42.5 degrees C) When hyperthermia continued at the same temperature for 2 seconds or more, the temperature was regarded as the heating temperature, and the cumulative time was defined as the thermal dose which was administered during the heating period.


RESULTS
Nine patients were resectable and the remaining 5 patients were categorized as non-resectable. The treatment effect was evaluated by an esophagram and an endoscopic examination both pre- and post-hyperthermo-chemoradiotherapy. Five patients were regarded to demonstrate a complete response, while 2 showed a partial response and 8 demonstrated no change, respectively. The maximal cumulative heating time was 2,312 seconds in the complete response group, 1,811 seconds in the partial response group and 1,260 seconds in the no change group (p = 0.038). The minimal and average cumulative heating time did not show any correlation with the treatment effect.


CONCLUSIONS
Our results indicate that the thermal doses calculated by those formulas were adequate for clinical hyperthermia in esophageal cancer patients.
Kitamura
Kaoru
K
Department of Surgery and Science (Department of Surgery II), Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. kao@surg2.med.kyushu-u.ac.jp
Ishida
Mayumi
M
Kimura
Yasue
Y
Saeki
Hiroshi
H
Maehara
Yoshihiko
Y
Sugimachi
Keizo
K
D000970:Antineoplastic Agents / Q000008:administration & dosage; D016009:Chi-Square Distribution; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D011859:Radiography; D011879:Radiotherapy Dosage; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D002945:Cisplatin