Neoadjuvant Radiochemotherapy Combined with Locoregional Hyperthermia in Locally Advanced Rectal Cancer: Feasibility...

Area of Science:

• Oncology
• Radiotherapy
• Medical Physics

Background:

• Integrating deep regional hyperthermia (HT) with neoadjuvant chemoradiotherapy (CRT) shows potential for enhancing treatment efficacy in locally advanced rectal cancer (LARC).
• Limited feasibility and tolerance data exist for HT combined with both short-course (SCRT) and long-course (LCRT) radiotherapy (RT) regimens in LARC.

Purpose of the Study:

• To evaluate the feasibility and tolerance of deep radiative HT integrated with neoadjuvant CRT in LARC patients.
• To assess HT delivery precision and patient outcomes across SCRT and LCRT schedules.

Main Methods:

• A single-center prospective observational study involving 67 LARC patients receiving neoadjuvant RT and chemotherapy with deep radiative HT (ALBA 4D system).
• SCRT patients received two HT sessions; LCRT patients received ten, with planning guided by software and real-time thermometry.
• Feasibility defined as ≥50% session completion; tolerance assessed using QMHT, UMC, and CTCAE v4.03 scales.

Main Results:

• HT was feasible in 100% of SCRT and 63.6% of LCRT patients completing ≥50% of prescribed sessions.
• No grade ≥3 HT-related toxicities occurred; most symptoms were mild and transient (e.g., localized pain).
• Median T50 temperatures were 40.3 °C (SCRT) and 40.4 °C (LCRT); RT-to-HT interval averaged 42 min.

Conclusions:

• Deep radiative HT can be seamlessly integrated into both SCRT and LCRT neoadjuvant protocols for rectal cancer.
• High adherence, favorable tolerance, and reliable thermal control support the clinical implementation of HT in LARC treatment.
• The study provides initial Spanish experience but was not powered for comparative effectiveness or rare adverse event detection.