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Yasue kimura Last modified date:2020.06.26

Associate Professor / Department of Surgery and Sciences, Graduate School of Medical Sciences / Faculty of Medical Sciences

1. Backgrounds: Although definitive chemoradiotherapy (CRT) has been frequently applied for esophageal cancer, the treatment for residual or recurrent cases after definitive CRT is difficult. We have carried out chemotherapy combined with hyperthermia for such cases. The purpose of this study is to evaluate the efficacy and tolerability of salvage hyperthermochemotherapy for residual or recurrent esophageal cancer after definitive CRT.
Method: Hyperthermochemotherapy has been performed for eleven esophageal cancer patients between 2005 and 2009 in our hospital. Six patients were suffering from residual primary tumor after definitive CRT, while 5 patients who had been underwent curative esophagectomy were suffering from recurrent lymph nodes. S-1, CDDP plus 5-FU or CDGP were administered as anti-cancer drugs in combination with hyperthermia treatment for these patients. The patients were heated by radiofrequency (RF) capacitive equipment for 50min once or twice per week. The treatment was conducted for 2-26 cycles when one cycle is regarded as one cycle treatment.
Results: Hyperthermochemoradiotherapy was performed 4 patients and using CDDP and 5-FU or CDGP and 5-FU. Seven patients were salvage hyperthermo-chemotherapy after definitive CRT. Complete response (CR) was achieved in 2 patients after hyperthermochemotherapy and has been still alive without any recurrence 60 months. The status of stable disease (SD) was achieved for 8 -16 months (Median: 10 months) in 6 patients. Improvement of the symptoms such as dysphasia was recognized in another 3 patients. There was no severe (NCI-CTC Grade 3 or 4) adverse events.
Conclusion: Hyperthermia treatment is effective for outpatients and the adverse effects are minimal. We can recommend Hyperthermia treatment as salvage therapy in patients with residual or recurrent disease after definitive CRT for esophageal cancer, when the first-line of second-line chemotherapy are failure.