Abstract

Purpose

Modulated electro-hyperthermia (mEHT) may enhance the tumor response, although the effectiveness of combined neoadjuvant therapy remains unclear. Therefore, we investigated the role of mEHT with neoadjuvant therapy for locally advanced rectal cancer.

Materials and methods

Clinical data were analyzed for 120 patients who received neoadjuvant treatment for locally advanced rectal cancer (T3/4 or N+, M0) from May 2012 to December 2017. Capecitabine or 5-fluorouracil was administered along with radiotherapy. Patients were categorized into mEHT group (62 patients) and non-mEHT group (58 patients) depending on whether mEHT was added. Surgery was performed 6–8 weeks after the end of radiotherapy.

Results

The median age was 59 years (range, 33–83). The median radiation dose was significantly less for mEHT group (40 Gy) than for non-mEHT group (50.4 Gy). In mEHT group, 80.7% showed down-staging compared with 67.2% in non-mEHT group. For large tumors of more than 65 cm³ (mean), improved tumor regression was observed in 31.6% of mEHT group compared with 0% of non-mEHT group (p = .024). The gastrointestinal toxicity rate of mEHT group was 64.5%, which was found to be statistically significantly less than 87.9% of non-mEHT group (p = .010). The 2-year disease-free survival was 96% for mEHT group and 79% for non-mEHT group (p = .054).

Conclusion

The overall mEHT group had a comparable response and survival using less radiation dosing compared with standard care; the subgroup with large tumors showed improved efficacy for tumor regression after mEHT.

中文翻译：

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局部晚期直肠癌新辅助治疗期间调节性体温过高的有益作用

摘要

目的

尽管联合新辅助疗法的有效性尚不清楚，但调制电热疗法（mEHT）可能会增强肿瘤反应。因此，我们调查了mEHT与新辅助疗法在局部晚期直肠癌中的作用。

材料和方法

从2012年5月至2017年12月，对120例接受了局部晚期直肠癌（T3 / 4或N +，M0）新辅助治疗的患者的临床数据进行了分析。卡培他滨或5-氟尿嘧啶与放疗同时使用。根据是否添加了mEHT，将患者分为mEHT组（62例患者）和非mEHT组（58例）。放疗结束后6-8周进行手术。

结果

中位年龄为59岁（33-83岁）。mEHT组（40 Gy）的中位放射剂量显着低于非mEHT组（50.4 Gy）。在mEHT组中，分期降低的比例为80.7％，而非mEHT组为67.2％。对于大于65cm³（平均）的大肿瘤，在mEHT组中有31.6％的肿瘤消退改善，而非mEHT组为0％（p  = .024）。mEHT组的胃肠道毒性率为64.5％，在统计学上显着低于非mEHT组的87.9％（p  = .010）。mEHT组的2年无病生存率为96％，非mEHT组为79％（p  = .054）。

结论

与标准治疗相比，使用更少的放射剂量，整个mEHT组的反应和生存率相当；具有大肿瘤的亚组在mEHT后显示出改善的肿瘤消退功效。