A Case of Recurrent Esophageal Cancer Treated with Chemoradiation Combined with Long-term Hyperthermia Treatment

Abstract

Hyperthermia is a less invasive treatment than chemotherapy, radiotherapy and surgery. However, there has been no report about the safety of administering repeated hyperthermia treatments over a long period. This report describes a patient who received 86 hyperthermia treatments over the course of four years.
A 65-year-old man was diagnosed with advanced esophageal cancer in the middle portion of the thoracic esophagus. He underwent a subtotal esophagectomy with gastric tube reconstruction. Five months after surgery, recurrent lesions were revealed on a computed tomography (CT) examination in the upper mediastinum and left supraclavicular region. Chemoradiation with a total dose of 60 Gy was performed in combination with hyperthermia as an initial treatment for these recurrences. Concurrent chemotherapy consisted of cisplatin (CDDP) and 5-fluorouracil (5FU). Hyperthermia was applied with an RF-capacitive heating apparatus (Thermotron RF-8, Yamamoto Vinita, Osaka, Japan) for 50 minutes twice a week. On a CT examination at the end of two months, both of the recurrent masses had decreased in size. Therefore, chemotherapy using CDDP and tegafur-uracil (TS-1), combined with twice-weekly hyperthermia, was performed as an adjuvant therapy for two weeks. Subsequently, he continued to receive hyperthermia once a week or once every three weeks for 3.5 years. At present he has had no adverse effects associated with the hyperthermia and no recurrence.