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Evidence summaries

Concomitant Hyperthermia and Radiation Therapy for Treating Locally Advanced Rectal Cancer

Hyperthermia might possibly have an additional effect when added to radiotherapy in the treatment of advanced rectal cancer although the evidence is insufficient. It is not known if this effect is as strong as the combination of chemotherapy and radiotherapy. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 6 studies with a total of 520 subjects. After 2 years, overall survival (OS) was significantly better in the radiotherapy-hyperthermia (RHT) group compared to radiotherapy (RT) only group (HR 2.06, 95% CI 1.33 to 3.17; 4 studies, n=424), but this difference disappeared after a longer period (3, 4 and 5 year OS). A significant higher complete tumour response rate was observed in the RHT group (RR 2.81, 95% CI 1.22 to 6.45; 5 studies, n=506). Only 2 studies reported on acute toxicity; no significant differences were observed between the RT and the RHT group. Late toxicity data were not reported.

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment and inadequate intention-to-treat adherence), by inconsistency (heterogeneity in interventions), and by indirectness (radiotherapy schedules were different from the nowadays used).

    References

    • De Haas-Kock DF, Buijsen J, Pijls-Johannesma M, Lutgens L, Lammering G, van Mastrigt GA, De Ruysscher DK, Lambin P, van der Zee J. Concomitant hyperthermia and radiation therapy for treating locally advanced rectal cancer. Cochrane Database Syst Rev 2009 Jul 8;(3):CD006269. [PubMed]

Primary/Secondary Keywords