DF chemotherapy regimen combined with hyperthermia in advanced esophageal cancer in the application of
【Key Words】 DF
Abstract: Objective: To investigate the thermo-
chemotherapy for advanced esophageal cancer short-term effect.
Methods: DF (plus fluorouracil and cisplatin) chemotherapy regimen combined with hyperthermia for treatment of 37 patients with advanced esophageal cancer, to observe the short-term effect and toxicity. Results: DF chemotherapy regimen combined with hyperthermia for advanced esophageal
carcinoma high toxicity less. Conclusions: The thermo-
chemotherapy for advanced esophageal cancer have synergistic therapeutic effects.
Keywords: DF chemotherapy; hyperthermia; esophageal cancer; middle and late
January 2004 ~ February 2005, our hospital carried out the loss of timing of surgery in advanced esophageal cancer treated with DF regimens combined hyperthermia treatment, will now report on the results as follows.
1 Data and methods
The clinical data of 11
Patients in this group of 73 patients, male 45 cases, female 28 cases, endoscopic, X-ray barium meal and
pathological examination, diagnosed as esophageal cancer, of which 62 cases of squamous cell carcinoma, adenocarcinoma 11
cases; aged 45 to 78 years, with an average age of 63.3 years old; ? period of 65 cases, ? period of 8 cases. Lesion: six
cases of upper, middle 55 cases, 12 cases of lower segment. All cases were carried out chest, abdominal B-ultrasonography
or CT examination to determine whether a distant metastasis. 37 cases were randomly divided into treatment group and control group 36 cases, two groups were comparable.
121 treatment group and control group are therefore correspondingly
DF (cisplatin plus fluorouracil) chemotherapy DDP50mg/m2, intravenous drip, d4, 5; 5Fu300mg/m2, intravenous infusion, d1 ~ 5, at the same time with hydration, diuresis, vomiting. 21 days of a cycle of treatment ? 2 cycles after the evaluation
of efficacy of chemotherapy, after chemotherapy to monitor and record toxicity.
122 hyperthermia and temperature measurement
Infusion of chemotherapeutic agents in the treatment group exhausted within two hours hyperthermia. Using SR1000 hyperthermia machines, capacitive heating, the frequency 40.68 MHZ, the output power of 500 ~ 800W, reflectance rate control ? 10%. Positioning patients by imaging studies after taking supine and selecting the corresponding area of the treatment of two electrodes on the patient's chest placed in the back
electrode and the skin with water bladders separated in order to increase the patient's body surface electrodes, and the coupling At the same time cool. Set heating temperature of 43 ?, when the heating of regional skin temperature reached
38 ~ 40 ?, the regulator output, maintaining constant temperature 60 ~ 70min, twice a week, ? 2 times per patient
treated. As shown by a chest film would be a ~ 2 sensors tied to a nasal feeding tube through the nose down to the esophagus, the tumor measured ambient temperature.
Evaluation of esophageal cancer 21
? complete remission (CR): tumor completely disappeared, obstruction relief of symptoms, the patient can eat, observe the one year in a stable condition; ? partial remission (PR):
tumor shrinkage 1 / 2 or so, obstruction relief of symptoms, the patient can eat, observe the condition for six months
stability; ? condition no change (NC); ? disease progression
(PD). Efficient for the complete remission (CR) and partial
remission (PR) combined.
Two sets of short-term effect in Table 1. Table 1 73
patients with advanced esophageal cancer patients with short-
term effect compare the two groups (omitted)
According to WHO standards for assessing the development
of drug toxicity, the main adverse reactions in Table 2. Table 2 DF regimens combined hyperthermia toxicity observed table (omitted) reposted elsewhere in the paper for free download http://
Esophageal cancer is a common malignant tumor in China, one of the great majority of squamous cell carcinoma, a small number of adenocarcinoma, can be expanded in all directions, causing esophageal obstruction. Early esophageal cancer usually is not the typical symptoms may be manifested as
swallowing food varying degrees of discomfort, wait for the emergence of sexual swallowing difficulties have reached the late stage, there may be lymphatic, hematogenous metastasis, oppression, and other neurological symptoms, loss of
opportunity for surgical treatment, can only choose non-
surgical treatment. Radiotherapy is a recognized non-surgical
treatment for advanced esophageal cancer, one of the principal means, this group of patients have radiotherapy before admission, but the effect is not ideal, may be related to lesions longer, more related to hypoxic cells, resulting in uncontrolled partial and relapse.
With the research progress of chemotherapy, systemic chemotherapy in the treatment of advanced esophageal cancer
has occupied an important position. DF chemotherapy Clinical highly feasible, and patient compliance is good, low drug prices, it was reported in the literature DF regimen effective against squamous cell carcinoma and 44% . Accordingly, we have chosen this program to treat patients. The main toxicity
of this program showed ? 0, ? 0 digestive tract response
rate was 43.2%, compared Fan Qingxia et al  reported DF chemotherapy combined with radiotherapy for esophageal cancer incidence of gastrointestinal reactions 66.4% lower, and no ?
0 The emergence of bone marrow suppression, mild bone marrow suppression were not GCSF support treatment can be self-
healing. Side effects during hyperthermia hyperthermia sweating, after which does not affect the post-rehydration
Heat can directly kill tumor cells, leading to apoptosis of tumor cells and enhance tumor immune function. Because the characteristics of tumor blood supply, tumor center worse than the surrounding blood supply, the center mostly hypoxic cells
are not sensitive to chemotherapy against hyperthermia-
sensitive, peripheral cells are relatively enriched, compared with hyperthermia sensitive to chemotherapy, which hyperthermia in combination with chemotherapy can improve anti-tumor effect. Hyperthermia could undermine the stability of the cell membrane, so that increased permeability of the cell membrane, thereby increasing the cellular uptake and penetration of drugs to enhance intracellular drug concentration and reaction speed, but also on the drug-induced
inhibition of DNA damage repair. Heating allows tumor cells to DDP enhanced drug sensitivity [3,4], heat and 5Fu both the tumor cell cycle S-phase, for which we have chosen DF
chemotherapy regimen combined with hyperthermia treatment.
Thermo-chemotherapy after administration of the order of the first heat, or both simultaneously.
In this group were re-treated, there are 11 cases of
adenocarcinoma, 3 cases of narrow type of advanced esophageal cancer patients, the recent effective rate was 51.3%, and fir-
cho-kyu, Tibet reported by BLM (bleomycin) DDP regimen combined with heat therapy on a group of esophageal X-ray to
improve the rate of 50% of the efficacy of similar , reported in the literature compared with chemotherapy alone DF
efficiency of 44% of squamous cell carcinoma  is high, indicating thermo-chemotherapy for advanced esophageal cancer synergistic therapeutic effect. This group of patients with dysphagia improvement rate was 54.1% (20/37), quality of life has been significantly improved.
In short, DF chemotherapy regimen combined with
hyperthermia treatment of advanced esophageal cancer accurately, both a synergistic therapeutic effect, less toxic method is simple, worthy of clinical application.
1 Yan Sun, editor. Manual of clinical oncology. 4th edition. Beijing: People's Health Publishing House, 2003,323.
2 Fan Qingxia, Guo-Wen Li, Wang Ruilin, et al. DF
chemotherapy, radiotherapy reported efficacy of sequential therapy of esophageal cancer. Cancer Research, 1999,26 (5): 376 ~ 377.
3 Hou Baohua, Qing 3 China, Dongfeng Ying, et al. Hyperthermia combined with DDP-induced apoptosis in colorectal
cancer cells and bcl2 expression experiments. Hubei Medical University, 2000,21 (2): 132 ~ 135.
4 LI You-ming, Chen Weixing, Liu rely. Hyperthermia combined with cisplatin-induced apoptosis of human gastric
cancer MKN45 cell research. Zhejiang Medicine, 1998,20 (12): 739 ~ 740.
5 Sugimachi K, Kuwano H, Ide H, et al.Chemotherapy
combined with or without hyperthermia for patients with esophageal carcinoma: a prospective randomized trial.Int J Hyperthermia, 1994,10 (4): 485 ~ 493. Reposted elsewhere in the free papers Download Center http://