K. Furuta et al., SYNERGISTIC EFFECTS OF HYPERTHERMIA IN PREOPERATIVE RADIOCHEMOTHERAPYFOR RECTAL-CARCINOMA, Diseases of the colon & rectum, 40(11), 1997, pp. 1303-1312
PURPOSE: We investigated the effectiveness of hyperthermia added to pr
eoperative radiation and chemotherapy for the treatment of rectal carc
inoma. METHODS: Forty-one patients receiving preoperative radiation we
re divided into two groups, Group A (20 patients; receiving radiation,
hy perthermia, and chemotherapy) and Group B (21 patients, receiving
no hyperthermia). Total dose of radiation was 40.5 Gy. Hyperthermia wa
s administered using 8 MHz of radiofrequency. Rectal temperature reach
ed 42 degrees C. A total dose of 3,400 mg of fi-fluorouracil given by
suppository was used as the chemotherapeutic agent. Effect of the preo
perative treatment was assessed by tumor reduction on barium enema, hi
stologic findings of the resected specimens, area measurement of the r
esidual cancer tissue, and by silver-staining nucleolar organizer regi
on (AgNOR) score. RESULTS: Tumor reduction on barium enema was signifi
cantly greater in Group A than in Group B (P < 0.01). Excluding two ca
ses of mucinous carcinoma because a large acellular mucinous accumulat
ion added materially to the cancerous area, the ratio of residual canc
er area to total lesion size in Group A was significantly smaller than
in Group B (P < 0.05). AgNOR store of the resected tumor tended to be
smaller in Group A than in Group B. CONCLUSION: Addition of hyperther
mia resulted in a greater degree of tumor necrosis and was considered
to be useful as a preoperative treatment for rectal carcinoma.