In vitro experiments on therapeutic effect of different treatments on various cell groups. (a) Confocal microscopy showed that fewer cells survived in the combination therapy group than in the other three groups. (b) Cell proliferation analysis showed the lowest cell viability in the combination therapy group compared with the other groups (mean: herpes simplex virus [HSV] thymidine kinase [TK]/ganciclovir [GCV] plus radiofrequency hyperthermia [RFH], 0.56 [95% confidence interval {CI}): 0.44, 0.68] vs radiofrequency hyperthermia [RFH], 0.89 [95% CI: 0.82, 0.97]; HSV-TK/GCV, 0.71 [95% CI: 0.56, 0.86]; and phosphate-buffered saline, 1 [95% CI: 1, 1]; all P < .05). Error bar indicates standard deviation of cell viability. (c) In vitro quantitative bioluminescence analysis further demonstrated the lowest photon signal in cells treated with combination therapy (mean: HSV-TK/GCV plus RFH, 0.17 [95% CI: 0.01, 0.34] vs RFH, 0.85 [95% CI: 0.64, 1.07]; HSV-TK/GCV, 0.47 [95% CI: 0.10, 0.83]; and phosphate-buffered saline, 1.00 [95% CI: 1.00, 1.00]; P < .05). Error bar indicates standard deviation of relative photon. (d) Western blotting analysis confirmed increased expression of green fluorescent protein (GFP) in cells treated with RFH compared with cells without RFH treatment (mean: GFP/HSV-TK plus RFH, 2.11 [95% CI: 1.15, 3.07] vs GFP/HSV-TK, 1.00 [95% CI: 1.00, 1.00]; P < .05; six animals per group). Error bar indicates standard deviation of relative gene expression level. GAPDH = glyceraldehyde 3-phosphate dehydrogenase. * = P < .05, ** = P < .01, and *** = P < .001.