Long-term complete response in stage IVa esophageal squamous cell carcinoma treated with chemoradiotherapy and modulated electro-hyperthermia: A case report

doi:10.4251/wjgo.v18.i8.120982

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Report

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Oncol. Aug 15, 2026; 18(8): 120982
Published online Aug 15, 2026. doi: 10.4251/wjgo.v18.i8.120982

Long-term complete response in stage IVa esophageal squamous cell carcinoma treated with chemoradiotherapy and modulated electro-hyperthermia: A case report

Chih-Wu Cheng, Wen-Tyng Li, Yu-Ting Lee, Kam-Hong Kam, Yuk-Wah Tsang

Chih-Wu Cheng, Yuk-Wah Tsang, Department of Radiation Oncology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chia-Yi 60002, Taiwan

Chih-Wu Cheng, Wen-Tyng Li, Yuk-Wah Tsang, Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan 320314, Taiwan

Yu-Ting Lee, Department of Medical Oncology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan

Kam-Hong Kam, Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi 60002, Taiwan

Co-corresponding authors: Wen-Tyng Li and Yuk-Wah Tsang.

Author contributions: Cheng CW contributed to data curation, investigation, executed radiotherapy and wrote the manuscript; Li WT contributed to conceptualization, methodology, supervision, review and editing and project administration; Lee YT delivered chemotherapy and medical care, critical discussion; Kam KH contributed to surgical investigation and critical discussion; Tsang YW contributed to radiotherapy and modulated electro-hyperthermia prescription, treatment planning, review and editing; Li WT and Tsang YW contributed equally to this manuscript as co-corresponding authors. All authors approved final revision of the paper.

AI contribution statement: ChatGPT by OpenAI was used solely for English language editing, grammar correction, and improvement of manuscript readability during manuscript and answering-reviewers document preparation. AI tools were not used to generate scientific content, experimental data, statistical analyses, figures, results, or scientific conclusions. All study design, patient management, treatment planning, data acquisition, pathological interpretation, scientific analysis, and interpretation of findings were conducted independently by the authors. All figures, images, and scientific content were reviewed, verified, and approved by the authors prior to submission.

Supported by the Research Program of Ditmanson Medical Foundation Chia-Yi Christian Hospital, No. R112-017.

Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).

Corresponding author: Wen-Tyng Li, PhD, Associate Professor, Department of Biomedical Engineering, Chung Yuan Christian University, No. 200 Zhongbei Road, Zhongli District, Taoyuan 320314, Taiwan. wtli@cycu.edu.tw

Received: March 16, 2026
Revised: April 1, 2026
Accepted: May 19, 2026
Published online: August 15, 2026
Processing time: 144 Days and 22 Hours

Abstract

BACKGROUND

Unresectable locally advanced esophageal squamous cell carcinoma accompanied by severe systemic compromise, such as cachexia, infection, and anemia, is associated with extremely poor prognosis. Achieving durable complete remission in these patients remains uncommon. Adjunctive hyperthermia has been proposed to enhance the efficacy of chemoradiotherapy, but clinical evidence supporting long-term outcomes remains limited.

CASE SUMMARY

We report the case of a 51-year-old man with stage IVa (cT4N3M0) esophageal squamous cell carcinoma complicated by cachexia, severe anemia, and pneumonia. Following stabilization with intensive supportive care, including infection control, nutritional support, and blood transfusion, the patient underwent definitive concurrent chemoradiotherapy delivered by volumetric modulated arc therapy with cisplatin and 5-fluorouracil. Adjunctive modulated electro-hyperthermia was administered during radiotherapy. Treatment was completed without interruption, resulting in a complete response confirmed by endoscopy and computed tomography, and further supported by histopathological evaluation demonstrating a pathological complete response. The patient has remained disease-free for more than five years of follow-up.

CONCLUSION

Multimodal therapy combined with intensive supportive care may enable durable remission in selected patients with advanced esophageal squamous cell carcinoma.

Keywords: Esophageal squamous cell carcinoma; Chemoradiotherapy; Modulated electro-hyperthermia; Cachexia; Long-term complete response; Case report

Core Tip: This case report describes a patient with stage IVa esophageal squamous cell carcinoma complicated by severe cachexia, pneumonia, and anemia who achieved durable complete remission exceeding five years after definitive chemoradiotherapy combined with adjunctive electrohyperthermia. Despite multiple poor prognostic factors, aggressive multimodal therapy together with early intensive supportive care enabled successful treatment completion and long-term disease control. This case highlights the potential role of electrohyperthermia as an adjunct to chemoradiotherapy in improving outcomes in selected high-risk patients with advanced esophageal cancer with histopathological confirmation of complete response.