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International Journal of Clinical Oncology
Published in: International Journal of Clinical Oncology 2/2018

01-04-2018 | Original Article

Selecting patients for hyperthermia combined with preoperative chemoradiotherapy for locally advanced rectal cancer

Authors: Sang-Won Kim, Ji Woon Yea, Jae Hwang Kim, Mi Jin Gu, Min Kyu Kang

Published in: International Journal of Clinical Oncology | Issue 2/2018

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Abstract

Background

This study investigated the role of hyperthermia combined with preoperative concurrent chemoradiotherapy (CCRT) for locally advanced rectal cancer (LARC) according to hypoxic marker expression.

Methods

One hundred and nine LARC patients with tissue blocks available for immunohistochemical assessment of carbonic anhydrase 9 (CA9) expression were reviewed. CA9 expression was considered positive when the staining percentage of tumor cells was >25% (n = 31). Pelvic radiotherapy with a total dose of 39.6–45 Gy was delivered concurrently with fluorouracil-based chemotherapy. Hyperthermia was administered to 52 patients twice a week during CCRT. Treatment response and outcomes were compared between hyperthermochemoradiotherapy (HCRT) and CCRT groups.

Results

In patients with positive CA9 expression, the rates of downstaging (p = 0.060) and pathologic complete response (p = 0.064) tended to be higher in the HCRT group than in the CCRT group. Distant metastasis-free survival (p = 0.029) and cancer-specific survival (p = 0.020) were significantly worse in tumors with both positive CA9 expression and poor tumor response. Negative CA9 expression, presence of major tumor response, and the use of hyperthermia were significant favorable prognostic factors for cancer-specific survival after the first recurrence in multivariate analysis.

Conclusions

Hyperthermia might selectively enhance the preoperative treatment response in LARC with positive CA9 expression and offset the negative effect of hypoxia on prognosis. Pretreatment evaluation of hypoxia could aid in the selection of patients who might benefit from hyperthermia.
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Metadata
Title
Selecting patients for hyperthermia combined with preoperative chemoradiotherapy for locally advanced rectal cancer
Authors
Sang-Won Kim
Ji Woon Yea
Jae Hwang Kim
Mi Jin Gu
Min Kyu Kang
Publication date
01-04-2018
Publisher
Springer Japan
Published in
International Journal of Clinical Oncology / Issue 2/2018
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-017-1213-z

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