Pathological complete response and sphincter-sparing surgery after neoadjuvant radiochemotherapy with regional hyperthermia for locally advanced rectal cancer compared with radiochemotherapy alone

Abstract

The combination of regional hyperthermia and neoadjuvant radiochemotherapy may lead to an increased pCR rate in locally advanced rectal cancer. Patients with low-lying tumours especially may benefit when additional downsizing allows sphincter-preserving surgery.

Feasibility of modulated electro-hyperthermia in preoperative treatment for locally-advanced rectal cancer: Early phase 2 clinical results

“…In a phase 2 study by Rau et al [6], as much as 40.5% of patients experienced Grade 3 toxicities resulting in early cessation of hyperthermia. These findings were repeated in another retrospective study by Schroeder et al [7], which found that 34% of patients discontinued treatment within the 1 st three hyperthermia sessions. Most of these toxicities and discomforts are related to temperature, directly or indirectly.…”

Feasibility of modulated electro-hyperthermia in preoperative treatment for locally-advanced rectal cancer: Early phase 2 clinical results

“…In a phase 2 study by Rau et al [6], as much as 40.5% of patients experienced Grade 3 toxicities resulting in early cessation of hyperthermia. These findings were repeated in another retrospective study by Schroeder et al [7], which found that 34% of patients discontinued treatment within the 1 st three hyperthermia sessions. Most of these toxicities and discomforts are related to temperature, directly or indirectly.…”

Long-term local control and survival after preoperative radiochemotherapy in combination with deep regional hyperthermia in locally advanced rectal cancer

“…Despite missing evidence for improvements in DFS and DMFS by the addition of hyperthermia, further investigations in this field are warranted: First, and as shown before, hyperthermia can lead to higher tumour regression and downsizing which in turn may allow for sphincter preservation in patients with low lying tumours [13,21]. Second, in our cohort the intensified local treatment translated into excellent long-term local control.…”

Beneficial effects of modulated electro-hyperthermia during neoadjuvant treatment for locally advanced rectal cancer

“…Schroeder et al used the annular-phased-array technology, which was more complicated, expensive and burdening because of distinctly higher total power (>600 W for APA-systems versus 150 W for mEHT). Nevertheless the pCR rates were comparable [15].…”

Feasibility of modulated electro-hyperthermia in preoperative treatment for locally-advanced rectal cancer: Early phase 2 clinical results

“…In a phase 2 study by Rau et al [6], as much as 40.5% of patients experienced Grade 3 toxicities resulting in early cessation of hyperthermia. These findings were repeated in another retrospective study by Schroeder et al [7], which found that 34% of patients discontinued treatment within the 1 st three hyperthermia sessions. Most of these toxicities and discomforts are related to temperature, directly or indirectly.…”

Long-term local control and survival after preoperative radiochemotherapy in combination with deep regional hyperthermia in locally advanced rectal cancer

“…Despite missing evidence for improvements in DFS and DMFS by the addition of hyperthermia, further investigations in this field are warranted: First, and as shown before, hyperthermia can lead to higher tumour regression and downsizing which in turn may allow for sphincter preservation in patients with low lying tumours [13,21]. Second, in our cohort the intensified local treatment translated into excellent long-term local control.…”

Beneficial effects of modulated electro-hyperthermia during neoadjuvant treatment for locally advanced rectal cancer

“…Schroeder et al used the annular-phased-array technology, which was more complicated, expensive and burdening because of distinctly higher total power (>600 W for APA-systems versus 150 W for mEHT). Nevertheless the pCR rates were comparable [15].…”

Feasibility of modulated electro-hyperthermia in preoperative treatment for locally-advanced rectal cancer: Early phase 2 clinical results

“…In a phase 2 study by Rau et al [6], as much as 40.5% of patients experienced Grade 3 toxicities resulting in early cessation of hyperthermia. These findings were repeated in another retrospective study by Schroeder et al [7], which found that 34% of patients discontinued treatment within the 1 st three hyperthermia sessions. Most of these toxicities and discomforts are related to temperature, directly or indirectly.…”

Long-term local control and survival after preoperative radiochemotherapy in combination with deep regional hyperthermia in locally advanced rectal cancer

“…Despite missing evidence for improvements in DFS and DMFS by the addition of hyperthermia, further investigations in this field are warranted: First, and as shown before, hyperthermia can lead to higher tumour regression and downsizing which in turn may allow for sphincter preservation in patients with low lying tumours [13,21]. Second, in our cohort the intensified local treatment translated into excellent long-term local control.…”

Beneficial effects of modulated electro-hyperthermia during neoadjuvant treatment for locally advanced rectal cancer

“…Schroeder et al used the annular-phased-array technology, which was more complicated, expensive and burdening because of distinctly higher total power (>600 W for APA-systems versus 150 W for mEHT). Nevertheless the pCR rates were comparable [15].…”