Preoperative chemoradiation combined with regional hyperthermia for patients with resectable esophagealcancer.

Int J Hyperthermia. 2009 Feb;25(1):79-85. doi: 10.1080/02656730802464078.

Preoperative chemoradiation combined with regional hyperthermia for patients with resectable esophagealcancer.

Hulshof MCVan Haaren PMVan Lanschot JJRichel DJFockens POldenborg SGeijsen EDVan Berge Henegouwen MICrezee J.

Source

Department of Radiation Oncology, Academical Medical Center, University of Amsterdam, The Netherlands. m.c.hulshof@amc.nl

Abstract

PURPOSE:

To analyse the treatment results of neo-adjuvant chemoradiation combined with regional hyperthermia in patients with resectable esophagealcancer.

PATIENTS AND METHODS:

Between August 2003 and December 2004, 28 patients entered a phase II study combining chemoradiation over a 4.5-week period with five sessions of regional hyperthermia. Chemotherapy consisted of carboplatin (AUC = 2) and paclitaxel (50 mg/m(2)) and radiotherapy of 41.4 Gy in 1.8 Gy daily fractions. Locoregional hyperthermia was applied using the AMC phased array of four 70 MHz antennas, aiming at a stable tumor temperature of 41 degrees C for one hour. Carboplatin was infused during the hyperthermia session. Esophageal resection was planned at 6-8 weeks after the end of radiotherapy. The majority of the patients had a T3 tumor (86%) and were cN+ (64%). Median follow-up for survivors was 37 months (range 31-46).

RESULTS:

Twenty-five patients (89%) completed the planned neo-adjuvant treatment and acute toxicity was generally mild. Twenty-six patients were operated on. A pathologically CR, PRmic, PR and SD were seen in 19%, 27%, 31% and 23% respectively. All patients had a R0 resection. In-field locoregional control during follow up for the operated patients was 100%. Quality of life was good for patients without disease progression. Survival rates at one, two and three years were 79%, 57% and 54% respectively.

CONCLUSION:

Neo-adjuvant chemoradiation combined with regional hyperthermia followed by esophageal resection for patients with esophageal cancerresulted in good locoregional control and overall survival.

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