Characteristics of the response of soft tissue sarcoma to hyperthermia: The correlation between temperature distribution, radiological examination and histology

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Abstract
Nineteen patients with soft tissue sarcoma were treated by a combination modality of hyperthermia and radiation or chemotherapy. There were 26 treatment sites. The size of the tumors ranged from 2.5 .times. 2 cm to 24 .times. 26 cm. Hyperthermic treatments were given twice a week, for a total of five to 14 sessions. Twenty-one tumors were treated by hyperthermia combined with radiotherapy, 2 Gy daily, five times a week, for a total of 40-78 Gy. Three tumors were treated by hyperthermia and arterial infusion of adriamycin, 100-120 mg in five or six treatments. For the superficial tumors the complete response rate was 40 percent, and for the deep-seated tumors 6.2 percent. Among the 12 tumors with no response, nine in which the treatment was evaluated as effective histologically (necrosis of the tumor) and by X-ray CT findings (development of a prominent hypodensity area) were included. Six cases were studied to correlate the X-ray CT findings, angiography and histological findings before and after hyperthermic treatment. The data were also used to interpret the thermal curve. The increased hypodensity area was roughly proportional to the development of necrosis, but there was one case in which hypodensity was not correlated with the necrosis. On the contrary, even in the contrast-enhanced area around the tumor in which the presence of residual tumor was strongly suspected clinically, no tumor cells were visualized. Clinical evaluation of the effect by size of the tumor can be supplemented by CT findings and histology, but should be cautiously adopted.

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