부산대학교 도서관

To avoid colostomy, we try to improve local control, i.e. to perform pathological complete response (pCR) by the neoadjuvant chemoradiation (NACR) with concurrent thermal therapy, falling into a so-called “wait-and-see policy”. The aim of this study is examined whether the treatment response of NACR with concurrent thermal therapy for rectal cancer can be predicted after the treatment completion and we showed the changing history of our treatment protocol, current results of our study and a new perspective and potential role of thermal therapeutic approaches in patients with rectal cancer. In this study, 81 patients with rectal cancers (54 resected, M:F=61:20, median age 63 years old (33-89), from December 2011 to May 2015) were received intensity-modulated radiotherapy (IMRT) (total dose 50 Gy/25 fractions) with capecitabine (1,700 mg/m2/day) for five weeks. Thermal therapy was performed using the Thermotron-RF 8, once a week for 5 weeks with 50 min irradiation. Clinical complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) were shown in 33.4%, 38.3%, 12.3%, and 16.0% of the patients, respectively. Patients with a gross tumor volume (GTV) ≤ 32 cm3 and a radiofrequency (RF) output difference (RO difference) ≥ 0 Watt/min exhibited the rates of pathological complete response (pCR) 42.9% and complete response (CR) 71.4%, and those with RO difference<0 Watt/min, 23.1% and 92.3%, respectively. While, patients with a GTV ≥ 80 cm3 and a RO difference ≥ 0 Watt/min exhibited the rates of pCR and CR 23.1% and 30.8%, and those with RO difference<0 Watt/min, 0% and 0%, respectively. Skin temperature significantly changed in patients with a pathological grade 3 tumor compared both to those who had PD and other outcomes, in the difference RO ≥ 0 Watt group (p<0.05), but not in the difference RO<0 Watt group. These data suggest that patients with a small tumor (GTV ≤ 32 cm3) and a difference RO<0 Watt are enough to treat by NACR only and those with a large tumor (GTV ≥ 80 cm3) and a RO difference ≥ 0 Watt by NACR with concurrent with thermal therapy.