title: A novel strategy of radiofrequency hyperthermia (neothermia) in combination with preoperative chemoradiotherapy for the treatment of advanced rectal cancer: a pilot study.
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/m(2) 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.
authors: Division of Surgery, Hidaka Hospital, Gunma, Japan.
authors: Hisanori
authors: H
authors: Shoji
authors: Division of Surgery, Hidaka Hospital, Gunma, Japan.
authors: Masahiko
authors: M
authors: Motegi
authors: Division of Surgery, Hidaka Hospital, Gunma, Japan.
authors: Kiyotaka
authors: K
authors: Osawa
authors: Division of Radiology, Hidaka Hospital, Gunma, Japan.
authors: Noriyuki
authors: N
authors: Okonogi
authors: Division of Radiology, Hidaka Hospital, Gunma, Japan.
authors: Atsushi
authors: A
authors: Okazaki
authors: Division of Surgery, Hidaka Hospital, Gunma, Japan.
authors: Yoshitaka
authors: Y
authors: Andou
authors: Department of Oncology Clinical Development, Graduate School of Medicine, Gunma University, Gunma, Japan.
authors: Takayuki
authors: T
authors: Asao
authors: Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma, Japan.
authors: Hiroyuki
authors: H
authors: Kuwano
authors: Department of Radiation Oncology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
authors: Takeo
authors: T
authors: Takahashi
authors: Division of Cancer Diagnosis and Cancer Treatment, Hidaka Hospital, Gunma, Japan.
authors: Kyoji
authors: K
authors: Ogoshi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001831:Body Temperature; D017115:Catheter Ablation / Q000379:methods*; D059248:Chemoradiotherapy / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010865:Pilot Projects; D011300:Preoperative Care / Q000379:methods; D012004:Rectal Neoplasms / Q000628:therapy*; D016896:Treatment Outcome
keywords: 8 MHz radiofrequency capacitive heating device; capecitabine; hyperthermia; intensity-modulated radiotherapy; rectal cancer; reference point