Department of Surgery, Narita Memorial Hospital, Toyohashi, Aichi, Japan.
Radiological Technology, Department of Medical Technique, Narita Memorial Hospital, Toyohashi, Aichi, Japan.
Am J Case Rep. 2021 Aug 17;22:e931564. doi: 10.12659/AJCR.931564.
BACKGROUND Radiofrequency (RF) hyperthermia is commonly used as an adjunct to established treatment modalities such as chemotherapy and radiotherapy for the management of cancer patients. This case report aims to introduce the use of hyperthermia, in combination with chemotherapy, for the treatment of unresectable gastric cancer in a patient implanted with a vagus nerve stimulator (VNS). CASE REPORT A 55-year-old man with dermatomyositis, laryngeal squamous cell carcinoma in situ and double synchronous gastric cancer was found to have unresectable gastric disease during surgery despite neoadjuvant chemotherapy. Postoperatively, he received chemotherapy with RF hyperthermia. The patient had a VNS implant to treat epileptic seizures. VNS failure due to RF hyperthermia was an area of significant concern, and the procedures were completed with a full preparation to manage epileptic seizures in the event of its anticipated occurrence. Twenty-one thermotherapies were performed over 21 weeks. After 3 courses of S-1 chemotherapy (12 weeks) with RF hyperthermia without any adverse events, the regimen was changed to S-1+ CDDP combination chemotherapy (SP) and RF hyperthermia. The patient continued to receive treatment with a decrease in the size of the primary gastric tumors as well as lymph node metastases, without major adverse events, until he died due to disseminated disease. CONCLUSIONS We report the first case of unresectable gastric cancer with VNS implants in which chemo-hyperthermal therapy was safe and successful. This case report highlights the importance of providing a multidisciplinary treatment with appropriate measures for patients with intractable cancer who have received special treatments for underlying comorbidities.
射频（RF）热疗常用于联合化疗和放疗等已确立的治疗方式，以治疗癌症患者。本病例报告旨在介绍热疗联合化疗治疗植入迷走神经刺激器（VNS）的不可切除胃癌患者的应用。
一名 55 岁男性，患有皮肌炎、喉鳞状细胞原位癌和双同步胃癌，尽管接受了新辅助化疗，手术时仍发现胃部疾病无法切除。术后，他接受了 RF 热疗联合化疗。该患者因癫痫发作而植入 VNS。由于 RF 热疗，VNS 失败是一个非常关注的问题，因此在发生预期癫痫发作时，进行了充分的准备以管理癫痫发作。在 21 周内进行了 21 次热疗。在接受了 3 个疗程（12 周）的 S-1 化疗联合 RF 热疗（无不良反应）后，将方案改为 S-1+CDDP 联合化疗（SP）联合 RF 热疗。患者继续接受治疗，原发胃肿瘤和淋巴结转移均缩小，无重大不良反应，直至因播散性疾病死亡。
我们报告了首例植入 VNS 的不可切除胃癌病例，该患者接受化疗-热疗安全有效。本病例报告强调了为接受特殊治疗的难治性癌症患者提供多学科治疗并采取适当措施的重要性。
