How to control malignant ascites is one of the important problems for the patients with peritoneal carcinomatosis. In order to assess the efficacy of intraperotoneal hyperthermic chemoperfusion (IHCP), clinical outcome of the 8 patients who had malignant ascites and received IHCP was investigated. The origins of their peritoneal carcinomatosis were gastric cancer in 5 patients, ovarian cancer in 1 patient and unknown in 2 patients. IHCP was performed for 90120 minutes just after cytoreductive surgery under hypothermic general anesthesia. Heated perfusate with 10 μg/ml of mitomycin C (plus 1530μg/ml of CDDP in 2 patients) was circulated in the peritoneal cavity through a closed circuit. The inflow temperature and the outflow temperature of the perfusate were controlled to be 4446°C, and 4344°C, respectively. The mean amount of ascites of the 8 patients was 5425±3253 ml (120010000 ml). After the treatment, ascites disappeared in 7 of 8 patients (87.5%). The median ascites free duration of these 7 patients was 5 months (317 months). IHCP is suggested to be effective to control malignant ascites of the patients with severe peritoneal carcinomatosis. It may also give them better quality of life and opportunities to receive further treatment.

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Microarray profiling is a powerful approach to identify individual genes that may have important functions of a neoplasm. To identify a set of genes related to thermoradioresistancy of cervical carcinoma, we investigated a total of 19 patients with Stage IIIA to Stage IVB cervical cancer who underwent definitive thermoradiotherapy between May 1995 and August 2001. We compared the expression profiles of 8 thermoradiosensitive and 11 thermoradioresistant tumors obtained by punch biopsy before treatment using a cDNA microarray consisting of 23, 040 human genes. We selected 35 genes on the basis of a clustering analysis. One of these genes in thermoradioresistant tumors was already known to be associated with hypoxia-inducible factor 1A (HIF1A) that regulates the expression of a variety of genes encoding proteins related to angiogenesis and to anaerobic metabolism of cells exposed to hypoxic stress.
These results suggested that HIF1A gene might play a role of thermoradioresistancy in advanced-stage cervical carcinoma.

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An 8-year-old girl was admitted to hospital because of left hip and knee joint pain. We found a tumor in her left iliopsoas muscle, which was diagnosed as a synovial sarcoma. She received chemotherapy and radiotherapy at another hospital, but the tumor showed no response to the treatments. Metastatic humerus bone tumor developed, and she needed morphine derived analgesics. She was introduced to our hospital again, and we started hyperthermia treatment, after that her retroperitoneal tumor decreased in size. We have already performed hyperthermic therapy 27 times. She became not to ask for the analgetic drug and could go to school from her home. In this case, the significance of the treatment is that the tumor response was observed with hyperthermia alone.

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Purpose Although adriamycin (ADR) exhibits potent anti-tumor effects against malignant glioma cells in vitro, in vivo problems arise because drug delivery to tumor tissues is insufficient, due to the presence of the blood-brain barrier (BBB). However, disruption of the BBB following hyperthermia is well known. We report two cases of malignant glioma treated with intra-arterial chemotherapy during hyperthermia, with concentration of ADR expected to increase following hyperthermia.
Materials and Methods Case 1 involved a 27-year-old female and Case 2 involved a 38-year-old male, both with recurrent right frontal glioma. A cyst in Case 1 and a surgical resection cavity in Case 2 were located adjacent to the tumor, so reservoirs were placed in the cyst and resection cavity. One needle-type electrode was positioned in the tumor utilizing stereotactic procedures in each case.
ADR at 0.5 mg/kg was administrated into the right common carotid artery, and ADR concentration was measured sequentially for baseline values. One week later, the same dose of ADR was injected during hyperthermia, and ADR concentration in the cyst or cavity was sequentially measured by aspiration through the reservoir.
Results ADR concentration gradually increased 15-90 min after intra-arterial administration. Concentration was 4.5-fold higher in Case 1 and 3.6-fold higher in Case 2 following hyperthermia, compared to baseline. Neither case displayed major complications.
Conclusions Maximum concentration of ADR in solution during hyperthermia was higher than during chemotherapy alone.Disruption of the BBB by hyperthermia can be expected to act synergistically with chemotherapy.

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