Role of Hyperthermia in the Treatment of Gastrointestinal Cancers

Takeo Takahashi, J. Saitoh, N. Okonogi, A. Okazaki
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引用次数: 4

Abstract

Gastointestinal cancers continue to be a common health problem. Among gastrointestinal cancers,gastric and colorectal cancers are most common causes of cancer incidence and death worldwide. These are basically treated surgically,but multidisciplinary treatment is applied for locally advanced and recurrent cancers,and its main modality is chemoradiotherapy(CRT). Preoperative CRT is performed for locally advanced rectal cancer. On the other hand,postoperative CRT is viewed by many reports as the standard care for advanced stomach cancer in Western countries. Curative or preoperative CRT is a standard treatment for locally advanced esophageal cancer. There have been several reports on the combination of these with regional hyperthermia in which favorable therapeutic outcomes were achieved. Regarding hyperthermia, thermal enhancement by combination with radiation and various anticancer drugs has been reported in vitro and in vivo. Particularly,thermal enhancement by combination with novel anticancer drugs may lead to further improvement of the therapeutic outcome. For peritoneal dissemination of gastrointestinal cancers including stomach cancer, hyperthermic intraperitoneal chemotherapy has been shown to be effective,as expected. There is also a possibility of the combination of hyperthermia with immunotherapy. It is necessary to elucidate the mechanism of thermal enhancement and demonstrate the efficacy of hyperthermia by performing an appropriate clinical study.
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热疗在胃肠道肿瘤治疗中的作用
胃肠道癌症仍然是一个常见的健康问题。在胃肠道癌症中,胃癌和结直肠癌是全世界最常见的癌症发病率和死亡原因。这些基本上是手术治疗,但局部晚期和复发的癌症应用多学科治疗,其主要方式是放化疗(CRT)。局部晚期直肠癌术前行CRT。另一方面,在西方国家,术后CRT被许多报道视为晚期胃癌的标准治疗。治疗或术前CRT是局部晚期食管癌的标准治疗方法。已经有几篇关于这些与局部热疗结合的报道,其中取得了良好的治疗效果。关于热疗,辐射联合各种抗癌药物的热增强在体外和体内都有报道。特别是,与新型抗癌药物联合使用的热增强可能会进一步改善治疗结果。对于包括胃癌在内的胃肠道癌症的腹膜播散,正如预期的那样,腹腔内高温化疗已被证明是有效的。还有一种可能是热疗与免疫疗法相结合。有必要通过适当的临床研究来阐明热增强的机制并证明热疗的有效性。
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