4.4 Article

Beneficial effects of modulated electro-hyperthermia during neoadjuvant treatment for locally advanced rectal cancer

Journal

INTERNATIONAL JOURNAL OF HYPERTHERMIA
Volume 38, Issue 1, Pages 144-151

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/02656736.2021.1877837

Keywords

Rectal neoplasms; neoadjuvant therapy; radiotherapy; hyperthermia; lymph node

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Analysis of clinical data from 120 patients with locally advanced rectal cancer revealed that Purpose Modulated electro-hyperthermia (mEHT) combined with neoadjuvant therapy may enhance tumor response, reduce radiation doses, improve tumor regression, decrease gastrointestinal toxicity, and increase 2-year disease-free survival rate.
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 cm(3) (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.

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