The role of deep hyperthermia in IMRT in elderly patients with esophageal cancer: a retrospective cohort study

Abstract Purpose This study aimed to assess the clinical utility of deep hyperthermia in elderly patients with esophageal cancer(EC) who underwent intensity-modulated radiotherapy(IMRT). Patients and methods This retrospective analysis included 177 elderly patients with EC who underwent IMRT between...

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Main Authors: Mengjiao Wang, Jian Yang, Dafei Wang, Juying Zhou, Songbing Qin, Yang Jiao, Lili Wang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Radiation Oncology
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Online Access:https://doi.org/10.1186/s13014-025-02661-4
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author Mengjiao Wang
Jian Yang
Dafei Wang
Juying Zhou
Songbing Qin
Yang Jiao
Lili Wang
author_facet Mengjiao Wang
Jian Yang
Dafei Wang
Juying Zhou
Songbing Qin
Yang Jiao
Lili Wang
author_sort Mengjiao Wang
collection DOAJ
description Abstract Purpose This study aimed to assess the clinical utility of deep hyperthermia in elderly patients with esophageal cancer(EC) who underwent intensity-modulated radiotherapy(IMRT). Patients and methods This retrospective analysis included 177 elderly patients with EC who underwent IMRT between 2017 and 2023, 42 of whom had combined deep hyperthermia (HT). Propensity score matching (PSM) was used to balance the covariates between the thermoradiotherapy (HTRT) group and IMRT-alone groups. Treatment outcomes and toxicities were compared between the two groups. We used the Kaplan-Meier method to estimate survival curves and the log-rank test to compare survival curves. Cox multivariate analysis was performed to analyze the prognostic factors in these patients. Results After PSM (42 patients in each group), the HTRT group had a greater objective response rate (ORR) than the IMRT-alone group (83% vs. 62%, P = 0.028). The HTRT group had less radiotherapy-related toxicity, including a lower incidence of leukopenia (14% vs. 33%, P = 0.040) and RP grade ≥ 2 (P = 0.012). However, the 1-, 2-, and 3-year overall survival (OS) rates and 1-, 2-, and 3-year disease-free survival (DFS) rates were not significantly different (P = 0.730, 0.964). Grade ≥ 2 hypoproteinemia (odds ratio [OR] = 3.798, P = 0.004), radiotherapy dose ≤ 60 Gy (OR = 0.445, P = 0.006), and tumor location in the lower esophagus (OR = 0.387, P = 0.005) were adverse prognostic factors for OS. Hypoproteinemia grade ≥ 2 (OR = 3.676, P < 0.001) was also a crucial prognostic factor for DFS. Conclusion Adding deep hyperthermia to IMRT can improve the ORR in elderly patients with EC. In addition, it significantly reduces radiotherapy-related toxicity. Although this approach does not improve the long-term prognosis, it is still practical and has low toxicity, making it suitable for clinical use.
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spelling doaj-art-0d019259924b43baaf2fedc8f2b1233d2025-08-20T02:25:08ZengBMCRadiation Oncology1748-717X2025-05-012011910.1186/s13014-025-02661-4The role of deep hyperthermia in IMRT in elderly patients with esophageal cancer: a retrospective cohort studyMengjiao Wang0Jian Yang1Dafei Wang2Juying Zhou3Songbing Qin4Yang Jiao5Lili Wang6Department of Radiation Oncology, The First Affiliated Hospital of Soochow UniversityDepartment of Oncology, The Affiliated Yixing Clinical School of Medical School of Yangzhou UniversityDepartment of Radiation Oncology, Yixing Cancer HospitalDepartment of Radiation Oncology, The First Affiliated Hospital of Soochow UniversityDepartment of Radiation Oncology, The First Affiliated Hospital of Soochow UniversitySchool of Radiation Medicine and Protection, Medical College of Soochow UniversityDepartment of Radiation Oncology, The First Affiliated Hospital of Soochow UniversityAbstract Purpose This study aimed to assess the clinical utility of deep hyperthermia in elderly patients with esophageal cancer(EC) who underwent intensity-modulated radiotherapy(IMRT). Patients and methods This retrospective analysis included 177 elderly patients with EC who underwent IMRT between 2017 and 2023, 42 of whom had combined deep hyperthermia (HT). Propensity score matching (PSM) was used to balance the covariates between the thermoradiotherapy (HTRT) group and IMRT-alone groups. Treatment outcomes and toxicities were compared between the two groups. We used the Kaplan-Meier method to estimate survival curves and the log-rank test to compare survival curves. Cox multivariate analysis was performed to analyze the prognostic factors in these patients. Results After PSM (42 patients in each group), the HTRT group had a greater objective response rate (ORR) than the IMRT-alone group (83% vs. 62%, P = 0.028). The HTRT group had less radiotherapy-related toxicity, including a lower incidence of leukopenia (14% vs. 33%, P = 0.040) and RP grade ≥ 2 (P = 0.012). However, the 1-, 2-, and 3-year overall survival (OS) rates and 1-, 2-, and 3-year disease-free survival (DFS) rates were not significantly different (P = 0.730, 0.964). Grade ≥ 2 hypoproteinemia (odds ratio [OR] = 3.798, P = 0.004), radiotherapy dose ≤ 60 Gy (OR = 0.445, P = 0.006), and tumor location in the lower esophagus (OR = 0.387, P = 0.005) were adverse prognostic factors for OS. Hypoproteinemia grade ≥ 2 (OR = 3.676, P < 0.001) was also a crucial prognostic factor for DFS. Conclusion Adding deep hyperthermia to IMRT can improve the ORR in elderly patients with EC. In addition, it significantly reduces radiotherapy-related toxicity. Although this approach does not improve the long-term prognosis, it is still practical and has low toxicity, making it suitable for clinical use.https://doi.org/10.1186/s13014-025-02661-4RadiotherapyHyperthermiaEsophageal cancerEfficacy
spellingShingle Mengjiao Wang
Jian Yang
Dafei Wang
Juying Zhou
Songbing Qin
Yang Jiao
Lili Wang
The role of deep hyperthermia in IMRT in elderly patients with esophageal cancer: a retrospective cohort study
Radiation Oncology
Radiotherapy
Hyperthermia
Esophageal cancer
Efficacy
title The role of deep hyperthermia in IMRT in elderly patients with esophageal cancer: a retrospective cohort study
title_full The role of deep hyperthermia in IMRT in elderly patients with esophageal cancer: a retrospective cohort study
title_fullStr The role of deep hyperthermia in IMRT in elderly patients with esophageal cancer: a retrospective cohort study
title_full_unstemmed The role of deep hyperthermia in IMRT in elderly patients with esophageal cancer: a retrospective cohort study
title_short The role of deep hyperthermia in IMRT in elderly patients with esophageal cancer: a retrospective cohort study
title_sort role of deep hyperthermia in imrt in elderly patients with esophageal cancer a retrospective cohort study
topic Radiotherapy
Hyperthermia
Esophageal cancer
Efficacy
url https://doi.org/10.1186/s13014-025-02661-4
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