Thermoradiotherapy for local control of chest wall invasion in patients with advanced non-small cell lung cancer

Abstract.

Background: We tested the feasibility of hyperthermia combined with concurrent radiotherapy (thermoradiotherapy) for pain relief and local control of non-small cell lung cancer (NSCLC) invading to the chest wall.

Methods: Thirteen patients with advanced NSCLC (eight stage IIIB and five stage IV) and severe pain caused by chest wall invasion of tumor were treated with thermoradiotherapy. During the conventional fractionated radiotherapy period, 8-MHz radiofrequency capacitive hyperthermia was administered once or twice per week for a total of three to nine treatment sessions. Pain relief, objective tumor response, thermometry, and toxicity were evaluated.

Results: Twelve of the 13 patients (92%) experienced satisfactory pain relief, and objective tumor shrinkage was observed in 11 of the 13 patients (85%), including complete regression in two. The thermometry parameters of minimum and maximum intratumor temperatures, mean of all intratumor temperatures, and rate of the time during which intratumor temperature was 41°C or higher were 37.6 ± 0.8°C, 42.4 ± 0.7°C, 40.3 ± 0.3°C, and 80.1 ± 8.6%, respectively. Adverse reactions included local transient skin pain in three patients, but no major toxicity was observed.

Conclusion: Concurrent thermoradiotherapy for chest wall invasion by advanced NSCLC was feasible, with tolerable toxicity, and it may be effective for pain relief and local tumor control. Further studies comparing thermoradiotherapy and radiotherapy alone for such patient populations are warranted.