Radiofrequency thermal treatment with chemoradiotherapy for advanced rectal cancer

Shoji,Hisanori; Motegi,Masahiko; Osawa,Kiyotaka; Okonogi,Noriyuki; Okazaki,Atsushi; Andou,Yoshitaka; Asao,Takayuki; Kuwano,Hiroyuki; Takahashi,Takeo; Ogoshi,Kyoji

doi:10.3892/or.2016.4659

Radiofrequency thermal treatment with chemoradiotherapy for advanced rectal cancer

Authors:
- Hisanori Shoji
- Masahiko Motegi
- Kiyotaka Osawa
- Noriyuki Okonogi
- Atsushi Okazaki
- Yoshitaka Andou
- Takayuki Asao
- Hiroyuki Kuwano
- Takeo Takahashi
- Kyoji Ogoshi
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Affiliations: Division of Surgery, Hidaka Hospital, Gunma 370-0001, Japan, Division of Radiology, Hidaka Hospital, Gunma 370-0001, Japan, Department of Oncology Clinical Development, Graduate School of Medicine, Gunma University, Gunma 371-8511, Japan, Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma 371-8511, Japan, Department of Radiation Oncology, Saitama Medical Center, Saitama Medical University, Saitama 350‑8550, Japan, Division of Cancer Diagnosis and Cancer Treatment, Hidaka Hospital, Gunma 370-0001, Japan
Published online on: March 7, 2016 https://doi.org/10.3892/or.2016.4659
Pages: 2569-2575
Copyright: © Shoji et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

We previously reported that patients with a clinical complete response (CR) following radiofrequency thermal treatment exhibit significantly increased body temperature compared with other groups, whereas patients with a clinical partial response or stable disease depended on the absence or presence of output limiting symptoms. The aim of this study was to evaluate the correlation among treatment response, Hidaka radiofrequency (RF) output classification (HROC: termed by us) and changes in body temperature. From December 2011 to January 2014, 51 consecutive rectal cancer cases were included in this study. All patients underwent 5 RF thermal treatments with concurrent chemoradiation. Patients were classified into three groups based on HROC: with ≤9, 10-16, and ≥17 points, calculated as the sum total points of five treatments. Thirty-three patients received surgery 8 weeks after treatment, and among them, 32 resected specimens were evaluated for histological response. Eighteen patients did not undergo surgery, five because of progressive disease (PD) and 13 refused because of permanent colostomy. We demonstrated that good local control (ypCR + CR + CRPD) was observed in 32.7% of cases in this study. Pathological complete response (ypCR) was observed in 15.7% of the total 51 patients and in 24.2% of the 33 patients who underwent surgery. All ypCR cases had ≥10 points in the HROC, but there were no patients with ypCR among those with ≤9 points in the HROC. Standardization of RF thermal treatment was performed safely, and two types of patients were identified: those without or with increased temperatures, who consequently showed no or some benefit, respectively, for similar RF output thermal treatment. We propose that the HROC is beneficial for evaluating the efficacy of RF thermal treatment with chemoradiation for rectal cancer, and the thermoregulation control mechanism in individual patients may be pivotal in predicting the response to RF thermal treatment.

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