PREOPERATIVE COMBINED TREATMENT WITH RADIATION, INTRALUMINAL HYPERTHERMIA, AND 5-FLUOROURACIL SUPPOSITORIES FOR PATIENTS WITH RECTAL-CANCER

A clinical trial of a novel modality consisting of preoperative irradi ation and intraluminal hyperthermia therapy, with or without 5-fluorou racil (5-FU) suppositories, was conducted on 30 patients with rectal c ancer. To create hyperthermia in rectal cancer, an intraluminal electr ode connected to a radiofrequency system was devised. Patients were tr eated preoperatively with a total irradiation dose of 30 Gy, being 3 G y every 2 days, and 5 applications of hyperthermia given twice a week, with or without 5-FU suppositories, given as 100mg a day to a total o f 2,000mg. Twenty patients received irradiation, intraluminal hyperthe rmia, and 5-FU suppositories, being the three-combination treatment, a nd the remaining 10 received irradiation and intraluminal hyperthermia , being the two-combination treatment. Shrinkage of the rectal cancer was observed macroscopically in 26 patients, resulting in a flattened cancerous crater or shallow ulcer. Microscopic examination revealed a marked decrease in the number of cancer cells. In fact, three resected specimens showed no evidence of cancer cells microscopically. These s triking reductions in cancer size enabled us to successfully perform s uper-low anterior resections in four patients, with anastomoses being made just above the dentate line with a sufficiently safe margin. No s erious complications were encountered in this series.