CLINICAL-RESULTS OF TREATMENT OF ADVANCED ESOPHAGEAL-CARCINOMA WITH HYPERTHERMIA IN COMBINATION WITH CHEMORADIOTHERAPY

Chemoradiotherapy combined with hyperthermia was administered to 35 pa tients with advanced esophageal carcinoma who either required preopera tive treatment or had nonresectable disease. As a rule, each patient r eceived a total dose of 30 Gy in 15 daily fractions of 2 Gy, 5 d/wk. B leomycin or cisplatin, in combination with fluorouracil, was employed as chemotherapy. Hyperthermia was applied by intraluminal heating offi ce a week for a total of six sessions using an apparatus (IH-500T; Jap an Crescent Co Ltd; Tokyo, Japan) (radiofrequency, 13.56 MHz) with an intraesophageal applicator and two extracorporeal applicators placed o n the chest and back. This treatment method obtained a response rate o f 80%, consisting of a complete response rate of 22.9% and partial res ponse of 57.1%. In 15 cases, the tumor became resectable (resectabilit y rate, 42.9%) following treatment. The histologic study of the resect ed specimens revealed absence of viable tumor cells in five patients ( 33.3% of the resected cases) (markedly effective), and in six patients (40.0%), the combined therapy was considered to be moderately effecti ve. No complications considered due to hyperthermia itself were recogn ized. The overall 5-year survival rate was 11.8%. In conclusion, chemo radiotherapy combined with hyperthermia was locally effective, yieldin g an overall response of 80.0%. However, the prognosis of the patients remains unfavorable. Advanced esophageal carcinoma requires treatment taking into account lymphatic and hematogenic metastasis at the begin ning of treatment.