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Radiation Therapy and Hyperthermia Improve the Oxygenation of Human Soft Tissue Sarcomas¹

Departments of Radiation Oncology [D. M. B., T. V. S., L. R. P., M. W. D.], Pathology [L. J. L.], and Radiology [H. C. C.] and Divisions of Orthopedics, Department of Surgery [S. P. S., J. M. H.] and Biometry, Department of Community and Family Medicine [R. K. D.], Duke University Comprehensive Cancer Center, Durham, North Carolina 27710

The adverse prognostic impact of tumor hypoxia has been demonstrated in human malignancy. We report the effects of radiotherapy and hyperthermia (HT) on soft tissue sarcoma oxygenation and the relationship between treatment-induced changes in oxygenation and clinical treatment outcome. Patients receiving preoperative radiotherapy and HT underwent tumor oxygenation measurement pretreatment after the start of radiation/pre-HT and one day after the first HT treatment. The magnitude of improvement in tumor oxygenation after the first HT fraction relative to pretreatment baseline was positively correlated with the amount of necrosis seen in the resection specimen. Patients with <90% resection specimen necrosis experienced longer disease-free survival than those with 90% necrosis. Increasing levels of tumor hypoxia were also correlated with diminished metabolic status as measured by P-31 magnetic resonance spectroscopy.

¹ Supported by NIH Grant P01 CA42745.

² To whom requests for reprints should be addressed, at Department of Radiation Oncology, Box 3085, Duke University Medical Center, Durham, NC 27710. Phone: (919) 660-2119; Fax: (919) 684-3953.

Received 8/19/96. Accepted 10/16/96.

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