Summary
Hepatocellular carcinoma is a major malignant disease in parts of Africa and Asia, including Korea. Surgical resection, which represents the best hope for cure, is limited by the extent of the disease and the high incidence of concurrent liver cirrhosis in Korea. We designed a phase H trial of combined external radiotherapy and hyperthermia for hepatocellular carcinoma that was unresectable due to either locally advanced lesions or associated liver cirrhosis so as to evaluate the efficacy and the safety of this combination regimen. This trial was performed at Yonsei Cancer Center between April 1988 and July 1988. External radiotherapy was delivered to a total dose of 3060 cGy/3.5 weeks. Hyperthermia was applied twice a week for a total of six treatment sessions using an 8-MHz radiofrequency capacitive-type heating device, i. e., Thermotron RF-8 and Cancermia. In all cases, hyperthermia was carried out within 30 min of the radiotherapy for a period of 30–60 min. The temperature in the tumor was measured by inserting a thermocouple into the tumor mass under ultrasonographic guidance in patients who did not have a bleeding tendency. The tumor response was assessed by CT scan after completion of the designed treatment. No complete response was obtained. However, a symptomatic improvement in abdominal pain was observed in 78.6% of cases and a partial response was achieved in 40% of the patients. The most important factor affecting the tumor response was the type of tumor (single massive, 71.4%; diffuse infiltrative, 20%; multinodular, 0;P<0.005). The 1-year survival values determined for all patients and for the partial responders were 34% and 50%, respectively. The overall median duration of survival was 6.5 months. The median duration of survival for the partial responders was longer than that for the nonresponders (11 vs 5 months;P<0.05). A mild degree of heat sensation, fever, first-degree burns of the skin, and nausea were observed as treatment-related adverse reactions. In conclusion, although this study is being continued, the results obtained thus for indicate that combined radiotherapy and hyperthermia seem to be effective in providing local tumor control and pain palliation in unresectable hepatocellular carcinoma while producing an acceptable level of toxicity.
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References
Ingold JA, Reed GB, Kaplan HS, Bagshaw MA (1965) Radiation hepatitis. AJR 93:200
Jung HC, Kim CY (1988) The serological profiles of hepatitis B virus infection and the prevalence rate of underlying liver cirrhosis in patients with primary liver cancer in Korea. Korean J Gastroenterol 20: 132
Kew MC, Geddes EW (1982) Hepatocellular carcinoma in rural southern African blacks. Medicine 61: 98
Kim BS, Yoo HS, Park YJ, Loh JJK (1989) Current status and future aspects on treatment of liver cancer. Cancer Chemother Pharmacol 23 [Suppl]:S118
Kim CY, Suh DJ, Kim ST, Lee HS (1977) α-Fetoprotein and HBsAg in Korean patients with hepatoma. Korean J Intern Med 20: 229
Kim IS, Kim HJ, Kim BS, Oh HC, Lee Y (1984) The cancer registry program in Kangwha county: the first report (July 1982–June 1984). Korean J Epidemiol 6: 100
Kwon TS, Lee SM, Park BK, Chung KB, Doh SG (1980) Clinical observation on 252 cases of primary hepatic cancer. Korean J Intern Med 23: 393
Loh JJK, Seong JS, Suh CO, Kim GE, Chu SS, Park KR, Lee CG, Kim BS, Kim GS, Seel DJ (1989) Cooperative clinical studies of hyperthermia using a capacitive type heating device, GHT-RF8. Yonsei Med J 30: 72
Nakashima T, Okuda K, Kojiro M, Jimi A, Yamaguchi R, Sakamoto K, Ikari T (1983) Pathology of hepatocellular carcinoma in Japan: 232 consecutive cases autopsied in ten years. Cancer 51:863
Phillips R, Murikami K (1960) Primary neoplasms of the liver. Results of radiation therapy. Cancer 13:714
Ries MC, Milligan AJ, Merrick HW, Dobelbower RR (1988) Biochemical and cellulareffects of radiofrequency induced interstitial hyperthermia on normal canine liver. Int J Radiat Oncol Biol Phys 14:529
Suh CO, Loh JJK, Seong JS, Roh JK, Kim BS, Park IS, Choi HJ (1980) Effect of radiofrequency hyperthermia on hepatocellular carcinoma. J Korean Cancer Res Assoc 20: 117
Wharton JT, Delclos L, Gallager S, Smith JP (1973) Radiation hepatitis induced by abdominal irradiation with the cobalt 60 moving strip technique. AJR 117: 73
Yoo HS, Suh JH, Lee JT, Kim KW, Kim DI, Kim BS, Choi HJ, Lee KS (1990) Nodular hepatocellular carcinoma — treatment with intraarterial injection of131I lipiodol. J Korean Med Sci 5: 75
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Kim, B.S., Chung, H.C., Seong, J.S. et al. Phase II trial for combined external radiotherapy and hyperthermia for unresectable hepatoma. Cancer Chemother. Pharmacol. 31 (Suppl 1), S119–S127 (1992). https://doi.org/10.1007/BF00687121
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DOI: https://doi.org/10.1007/BF00687121