BackgroundFor many years, the standard treatment of advanced cervical carcinoma has been radiotherapy (RT). However, locoregional failure rates of RT for Stage III or Stage IV cervical carcinoma are high. To clarify the role of thermoradiotherapy (TRT ; radiotherapy plus hyperthermia) for FIGO Stage IIIB cervical carcinomas, we investigated both the clinical response and survival of patients treated with radio- or thermoradiotherapy. On the other hand, to identify a set of genes related to thermoradiosensitivity of cervical carcinoma, we compared the expression profiles of thermoradiosensitive and thermoradioresistant tumors using a cDNA microarray analysis.A randomized clinical trials in our study and published trialsIn our randomized trials, forty patients with Stage IIIB uterine cervix carcinoma were divided randomly into the following two groups : the RT group of 20 patients who underwent RT alone, and the TRT group of 20 patients who underwent three sessions of hyperthermia in addition to RT. A complete response was achieved in 50% in the RT group versus 80% in the TRT group (P = 0.048). Both the 5-year overall survival and disease-free survival of the patients who were treated with TRT (58.2% and 63.6%) were better than those of the patients treated with RT (48.1% and 45%), but these differences were not significant. The 5-year local relapse-free survival of the patients who were treated with TRT (79.7%) was significantly better than that of the patients treated with RT (48.5%) (P = 0.048).Six randomized trials comparing the results of RT alone with TRT have been published, of which four showed significant better complete response, locoregional tumor control and/or disease-free survival rates. One trial showed a trend of better locoregional tumor control and one did not show any benefit.Prediction of advanced cervical carcinoma after thermoradiotherapy using microarray analysis in our previous studyA total of 19 patients with Stage III-IV cervical cancer who underwent definitive thermoradiotherapy were included in this study. We compared the expression profiles of 8 thermoradiosensitive and 11 thermoradioresistant tumors obtained by punch biopsy before treatment using a cDNA microarray. We selected 35 genes on the basis of a clustering analysis, and confirmed the validity of these genes with a cross validation test. Some of these genes were already known to be associated with apoptosis (BIK, TEGT), hypoxia-inducible gene (HIF1A), and tumor cell invasion and metastasis (PLAU). These results may eventually lead to the achievement of “personalized therapy” for this disease.