Mild hyperthermia with magnetic resonance- guided high intensity focused ultrasound combined with salvage chemoradiation for recurrent rectal cancer.

IF 3 3区 医学 Q2 ONCOLOGY
International Journal of Hyperthermia Pub Date : 2024-01-01 Epub Date: 2024-06-19 DOI:10.1080/02656736.2024.2365385
Jonathan Peng, Ari Partanen, Samuel Pichardo, Robert Staruch, Kaitlyn Perry, Merrylee McGuffin, Yuexi Huang, Kelvin Kw Chan, Shun Wong, Greg Czarnota, Kullervo Hynynen, William Chu
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Abstract

Introduction: Pelvic recurrences from rectal cancer present a challenging clinical scenario. Hyperthermia represents an innovative treatment option in combination with concurrent chemoradiation to enhance therapeutic effect. We provide the initial results of a prospective single center feasibility study (NCT02528175) for patients undergoing rectal cancer retreatment using concurrent chemoradiation and mild hyperthermia with MR-guided high intensity focused ultrasound (MR-HIFU).

Methods: All patients were deemed ineligible for salvage surgery and were evaluated in a multidisciplinary fashion with a surgical oncologist, radiation oncologist and medical oncologist. Radiation was delivered to a dose of 30.6 Gy in 1.8 Gy per fraction with concurrent capecitabine. MR-HIFU was delivered on days 1, 8 and 15 of concurrent chemoradiation. Our primary objective was feasibility and toxicity.

Results: Six patients (total 11 screened) were treated with concurrent chemoradiation and mild hyperthermia with MR-HIFU. Tumor size varied between 3.1-16.6 cm. Patients spent an average of 228 min in the MRI suite and sonication with the external transducer lasted an average of 35 min. There were no complications on the day of the MR-HIFU procedure and all acute toxicities (no grade >/=3 toxicities) resolved after completion of treatment. There were no late grade >/=3 toxicities.

Conclusion: Mild hyperthermia with MR-HIFU, in combination with concurrent chemoradiation for appropriately selected patients, is safe for localized pelvic recurrences from rectal cancer. The potential for MR-HIFU to be applied in the recurrent setting in rectal cancer treatment requires further technical development and prospective evaluation.

磁共振引导下的高强度聚焦超声轻度热疗联合挽救性化疗治疗复发性直肠癌。
引言直肠癌盆腔复发是一个具有挑战性的临床问题。热疗是一种创新的治疗方法,与同期化疗相结合可增强疗效。我们提供了一项前瞻性单中心可行性研究(NCT02528175)的初步结果,该研究针对接受直肠癌再治疗的患者,采用了MR引导下高强度聚焦超声(MR-HIFU)同时化疗和温和热疗:所有患者都被认为不符合挽救手术的条件,并接受了肿瘤外科医生、肿瘤放射科医生和肿瘤内科医生的多学科评估。放疗剂量为30.6 Gy,每部分1.8 Gy,同时使用卡培他滨。MR-HIFU在化疗的第1、8和15天进行。我们的主要目标是可行性和毒性:6名患者(共筛选出11名患者)接受了MR-HIFU同期化疗和轻度热疗。肿瘤大小在3.1-16.6厘米之间。患者在核磁共振成像室平均用时228分钟,使用外部换能器进行超声治疗平均用时35分钟。MR-HIFU手术当天无并发症,所有急性毒性(无>/=3级毒性)均在治疗结束后缓解。结论:MR-HIFU治疗的轻度高热在治疗结束后即可缓解:结论:MR-HIFU轻度热疗与适当选择的化疗相结合,对直肠癌盆腔局部复发是安全的。MR-HIFU在直肠癌复发治疗中的应用潜力还需要进一步的技术开发和前瞻性评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.90
自引率
12.90%
发文量
153
审稿时长
6-12 weeks
期刊介绍: The International Journal of Hyperthermia
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