[Experimental and clinical studies on preoperative combined therapy using hyperthermia in carcinoma of the esophagus]

In order to develop a new multidisciplinary treatment for carcinoma of the esophagus, we evaluate the effect of hyperthermia experimentally and clinically. Antitumor effect for squamous cell carcinoma arising spontaneously in a C3H/He Mouse is proved using hyperthermia only, and combined hyperthermia with irradiation and chemotherapy. Inhibited growth of tumor can lead to decrease of distant metastasis (Pulmonary metastasis). And hyperthermia itself does not induce increase of metastasis. There is a total of 32 patients of esophageal carcinoma receiving a preoperative combined treatment using hyperthermia. Nineteen patients received irradiation and hyperthermia. Thirteen received irradiation, immunochemotherapy and hyperthermia, Ef3 (complete disappearance of cancer cells) is obtained in 26.3% with the treatment using irradiation and hyperthermia, and 46.1% of Ef3 is found using irradiation, immunochemotherapy and hyperthermia. The above mentioned results are more favorable than the usual treatment using irradiation and immunochemotherapy without hyperthermia. Serrated, spiral, funnel type of esophagogram were used to be radiation resistant, however a satisfactory histological effect could be obtained by hyperthermia in addition to conventional irradiation. Because a high percentage of Ef3 is revealed even in A3 (invasion into the neighboring structures) cases, we can extend our indication of operation and our rate of curative resection is increased. Moreover, postoperative early local recurrence is decreased and it seems to improve the short term survival rate (3 years survival). We were afraid that combined treatment using hyperthermia might enhance remote lymph nodes metastases. But present study proves that it is not true. In conclusion, we recommend combined treatment using hyperthermia for A3 cases those are seemed to be difficult to resect because of invasion into the neighboring structures.