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Hyperthermia in the Multimodal Therapy of Advanced Rectal Carcinomas

  • Conference paper
New Perspectives in Molecular and Clinical Management of Gastrointestinal Tumors

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 142))

Abstract

The synergistic effects of hyperthermia (raising temperatures to 40°C and above) when combined with radiotherapy and cytotoxic drugs and a modulation of immunological phenomena have been demonstrated in the laboratory. Pre-clinical data relating to hyperthermia are summed up, along with their implications for clinical application. Controlled studies of local and regional hyperthermia have been performed during recent years, and these show us that the adjunction of hyperthermia provides at least an improvement of local control compared with radiotherapy alone. Current clinical results are summarized. Therapy systems based on radiowave irradiation have been commercially available for regional hyperthermia of the pelvis since the mid 1980s. This technology allows us to perform sufficiently tolerable and effective regional hyperthermia on rectal carcinomas. Used as part of curative preoperative and postoperative multimodal therapeutic strategies, hyperthermia can lead to improvement in local control (resectability, down-staging, progression-free time, recurrence rate), at least for certain risk groups. The preoperative radio-chemo-thermotherapy of advanced primary and recurring rectal carcinoma, uT3/4, was tested in a phase-I/II study of 20 patients. Therapy procedure, acute toxicity, thermal parameters, and response are described and discussed for this patient group. The regimen proved to be sufficiently tolerable, and complications did not occur. Tumor resection was performed on 14 of the 20 patients; 13 of the procedures were RO-resections and one was an R2 resection. In 64% of the resected rectal carcinomas, histopathological down-staging of the pretherapeutic endosonographical stadium was achieved; in three of the patients, despite continued non-resectability, local control has now been maintained for more than 12 months. In two patients with nonresectable rectal carcinomas, local progress was seen during the neoadjuvant combination therapy.

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Authors and Affiliations

  1. Department of Radiation Oncology, Rudolf Virchow University Clinic, Augustenburger Platz 1, 13344, Berlin, Germany

    P. Wust, J. Gellermann, H. Stahl & R. Felix

  2. Department of Surgery, Robert-Rössle Hospital, Humboldt University, Lindenberger Weg 80, 13122, Berlin, Germany

    B. Rau, T. J. Vogl & P. M. Schlag

  3. Department of Medical Oncology, Rudolf Virchow University Clinic, Augustenburger Platz 1, 13344, Berlin, Germany

    J. Löffel, A. Speidel & H. Riess

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  1. P. Wust
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  2. J. Gellermann
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  3. B. Rau
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  4. J. Löffel
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  5. A. Speidel
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  6. H. Stahl
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  7. H. Riess
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  8. T. J. Vogl
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  9. R. Felix
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  10. P. M. Schlag
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Editors and Affiliations

  1. Fachbereich Humanmedizin, Univ.-Klinikum Benjamin Franklin, Medizinische Klinik und Poliklinik, Schwerpunkt Hämatologie und Onkologie, Freie Universität Berlin, Hindenburgdamm 30, 12200, Berlin, Germany

    Ernst-D. Kreuser

  2. Robert-Rössle Klinik am Max-Delbrück-Centrum, Humboldt-Universität, Lindenberger Weg 80, 13122, Berlin, Germany

    P. M. Schlag

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© 1996 Springer-Verlag Berlin Heidelberg

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Wust, P. et al. (1996). Hyperthermia in the Multimodal Therapy of Advanced Rectal Carcinomas. In: Kreuser, ED., Schlag, P.M. (eds) New Perspectives in Molecular and Clinical Management of Gastrointestinal Tumors. Recent Results in Cancer Research, vol 142. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80035-1_18

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  • DOI: https://doi.org/10.1007/978-3-642-80035-1_18

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