Preoperative Hyperthermochemoradiotherapy for Patients with Rectal Cancer

术前热化疗放疗（HCR疗法）包括42 - 45 ℃下40分钟的热疗（每周2次，持续2周）、5-氟尿嘧啶（5-FU）或1-己基氨基甲酰基-5-氟尿嘧啶（HCFU），以及总计30戈伊的照射。该疗法最近在36例直肠癌患者术前处方。我们使用了一个射频系统，包括一个内导管电极与热传感器的热疗。术前HCR治疗的有效性通过灌注造影、纤维镜检查和切除标本的组织病理学结果进行评估。在所有评估模式下，大多数患者的肿瘤大小和数量明显减少。在组织学上，12名患者的切除标本中没有或只有少数活癌细胞，13名患者中有少量活癌细胞，11名患者中有相当数量的活癌细胞;没有并发症。本研究应用琥珀酸脱氢酶抑制试验对22例直肠癌活检组织进行了热辐射敏感性研究。热处理细胞的琥珀酸脱氢酶活性明显低于辐射处理细胞（P<0.01）。热辐射处理细胞的琥珀酸脱氢酶活性在癌组织中最低。虽然数量很小，但在9例病例中，有7例的临床结果与该测试相关。

Preoperative Hyperthermo-chemo-Radiotherapy (HCR therapy), consists of a combination of hyperthermia at 42 to 45^ﾟC for 40 minutes (2 times per week for two weeks), 5-fluorouracil (5-FU) or 1-hexylcarbamoyl-5-fluorouracil (HCFU), and a total of 30 Gy irradiation. The therapy was prescribed preoperatively most recently for 36 patients with rectal cancer. We used a radio-frequency system involving an endotract electrode with thermosensors for the hyperthermia. The effectiveness of preoperative HCR therapy was evaluated by irrigography, fiberscopy, and histopathologic findings in the resected specimens. Reduction in tumor size and amount was evident in most patients with all modes of assessment. Histologically, no or only a few viable cancer cells were seen in the resected specimens in twelve patients, a small number of viable cancer cells in thirteen, and a fair number of viable cancer cells in eleven patients ; there were no complications. This method of treatment is expected to play an important role in the interdisciplinary treatment for rectal cancer.The sensitivity to heat and radiation of 22 rectal cancer tissues obtained at biopsy was studied using the in vitro succinate dehydrogenase inhibition test. The succinate dehydrogenase activities of heat-treated cells were significantly lower than that of the radiation-treated cells (P<0.01). The succinate dehydrogenase activities of heat plus radiation treated cells were the lowest in tissues from cancer lesions. Although the number was small, there was a correlation between this test and clinical outcome in seven of nine cases.