Shoji Hisanori, Motegi Masahiko, Osawa Kiyotaka, Okonogi Noriyuki, Okazaki Atsushi, Andou Yoshitaka, Asao Takayuki, Kuwano Hiroyuki, Takahashi Takeo, Ogoshi Kyoji
Division of Surgery, Hidaka Hospital, Gunma, Japan.
Division of Radiology, Hidaka Hospital, Gunma, Japan.
Cancer Med. 2015 Jun;4(6):834-43. doi: 10.1002/cam4.431. Epub 2015 Feb 9.
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.
8兆赫射频（RF）电容式加热设备进行的每周区域热疗在直肠癌中的安全性已得到证实。我们旨在规范热疗治疗，以便进行科学评估并评估直肠癌对RF热疗的局部肿瘤反应。49例被诊断为直肠腺癌的患者纳入本研究。所有患者接受调强放射治疗，每周5天（剂量，50 Gy/25次），同时每周5天服用卡培他滨5次（每天1700 mg/m²），并使用8兆赫RF电容式加热设备每周照射1次，每次50分钟，共照射5次。33例患者在治疗8周后接受手术。3例患者因疾病进展（PD）未接受手术，13例拒绝手术。8例（16.3%）患者术后病理完全缓解（ypCR）。在未接受手术的患者中，3例（6.1%）达到临床完全缓解（CR），3例（6.1%）达到局部CR但远处有PD（CRPD）。90%的ypCR + CR患者出现在平均总累积照射输出为6.21 W min⁻¹ m⁻²/治疗或更高组，或总累积热输出为429°C min⁻¹ m⁻²或更高组。然而，有1例CRPD患者在总累积热输出较高组。我们提出了一种新的热疗定量参数，并证明患者可从温和温度的温和照射中获益。使用这些参数，在未来的多机构研究中可以确定这种治疗方式的确切输出、最佳热疗方案以及禁忌证或适应证。
