Hyperthermo-chemo-radiotherapy for patients with early carcinoma of the esophagus.

Hyperthermia combined with irradiation and chemotherapy (hyperthermo-chemo-radiotherapy) was prescribed pre-operatively for 21 patients with submucosal carcinoma of the esophagus, and its effectiveness was evaluated by a comparison with patients who also had massive submucosal carcinoma, but received no pre-operative treatment (n = 12). There was no difference in the survival rates of these groups (hyperthermo-chemo-radiotherapy group: 3-year survival in 56.6%), but the patients who responded well to the HCR therapy (n = 6) demonstrated better survival rates (3-year survival in 83.3%) than did the patients without any pre-operative treatment (3-year survival in 33.9%). An HCR sensitivity test using the succinate dehydrogenase inhibition test was devised and showed good correlation with the clinical remedial values (the diagnostic specificity was 0.89). An accurate diagnosis of the esophageal lesion and appropriate selection of potentially treatable cases are considered essential for the optimal use of HCR therapy in patients with submucosal carcinoma.