title: Chemoradiotherapy and concurrent radiofrequency thermal therapy to treat primary rectal cancer and prediction of treatment responses.
abstract: The present study aimed to evaluate a previously reported predictive formula of output-limiting symptoms induced by radiofrequency (RF) to determine the efficacy of this neoadjuvant chemoradiation (NACR) and concurrent RF thermal therapy. The present study included 81 consecutive patients with confirmed diagnoses of rectal adenocarcinoma that was localized in the mid-low rectum (up to 12 cm from the anal verge) who received NACR [intensity-modulated radiotherapy (IMRT), 50 Gy/25 fractions, capecitabine 1,700 mg/m2/day for 5 days/week)] with concurrent thermal therapy (Thermotron-RF8, once a week for 5 weeks with 50 min irradiation). Patients with progressive disease (PD) did not receive RF outputs higher than the predicted value. Some patients who were predicted to receive more output in fact received more than the predicted output. In patients who were predicted to receive moderately higher outputs, 37.5% of the patients experienced pathological complete responses, which was the highest rate, while in those who did not receive more than the predicted output, 66.7% of the patients experienced PD, which was the highest rate in the present study. We speculate that RF thermal therapy may offset the chemoradiation effects in some patients. Adding thermal therapy as a multimodality therapy to NACR potentially affects patients with lower predicted outputs and actual observed outputs slightly higher than the predictive value. Our predictive equation for initial energy output, in which output‑limiting symptoms can be used to predict treatment efficacy, consequently, can be used to decide whether to continue this treatment modality.
authors.affiliation: Division of Surgery, Hidaka Hospital, Gunma 370-0001, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Shoji
authors.affiliation: Division of Surgery, Hidaka Hospital, Gunma 370-0001, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Motegi
authors.affiliation: Oncology Center, Hidaka Hospital, Gunma 370-0001, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Takakusagi
authors.affiliation: Initiative for Advanced Research, Gunma University, Gunma 371-8511, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Asao
authors.affiliation: Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma 371-8511, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
authors.affiliation: Department of Radiation Oncology, Saitama Medical Center, Saitama Medical University, Saitama 350-8550, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Takahashi
authors.affiliation: Division of Cancer Diagnosis and Cancer Treatment, Hidaka Hospital, Gunma 370-0001, Japan.
authors.forename: Kyoji
authors.initials: K
authors.lastname: Ogoshi
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D050397:Radiotherapy, Intensity-Modulated; D012004:Rectal Neoplasms / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies