A pilot study to investigate skin and tumor thermal enhancement ratios of 41.5–42.0°c hyperthermia with radiation

Johnson, Richard J.; Sandhu, Taljit S.; Hetzel, Frederick W.; Song, Seung-Yil; Bicher, Haim I.; Subjeck, John R.; Kowal, Henry S.

doi:10.1016/0360-3016(79)90599-6

Cited by 25 publications

(2 citation statements)

References 10 publications

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“…A cursory examination of a 15 phase I/II clinical trial report conducted during the late 1970s and mid-1980s was done [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. All of the trials except one had a thermal treatment goal of >428C for 30-60 min.…”

Section: Clinical Consequencesmentioning

confidence: 99%

Re-setting the biologic rationale for thermal therapy

Dewhirst

Vujašković

Jones

et al. 2005

International Journal of Hyperthermia

282

199

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This review takes a retrospective look at how hyperthermia biology, as defined from studies emerging from the late 1970s and into the 1980s, mis-directed the clinical field of hyperthermia, by placing too much emphasis on the necessity of killing cells with hyperthermia in order to define success. The requirement that cell killing be achieved led to sub-optimal hyperthermia fractionation goals for combinations with radiotherapy, inappropriate sequencing between radiation and hyperthermia and goals for hyperthermia equipment performance that were neither achievable nor necessary. The review then considers the importance of the biologic effects of hyperthermia that occur in the temperature range that lies between that necessary to kill substantial proportions of cells and normothermia (e.g. 39-42 degrees C for 1 h). The effects that occur in this temperature range are compelling-including inhibition of radiation-induced damage repair, changes in perfusion, re-oxygenation, effects on macromolecular and nanoparticle delivery, induction of the heat shock response and immunological stimulation, all of which can be exploited to improve tumour response to radiation and chemotherapy. This new knowledge about the biology of hyperthermia compels one to continue to move the field forward, but with thermal goals that are eminently achievable and tolerable by patients. The fact that lower temperatures are incorporated into thermal goals does not lessen the need for non-invasive thermometry or more sophisticated hyperthermia delivery systems, however. If anything, it further compels one to move the field forward on an integrated biological, engineering and clinical level.

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Section: Clinical Consequencesmentioning

confidence: 99%

Re-setting the biologic rationale for thermal therapy

Dewhirst

Vujašković

Jones

et al. 2005

International Journal of Hyperthermia

282

199

View full text Add to dashboard Cite

show abstract

“…In recent years, hyperthermia alone or in combination with radiotherapy has become an interesting tool for treating certain cancers [Hahn, 19781. Local hyperthermia has been produced by hot water, microwaves, longer wavelength radiofrequency fields, or ultrasound [Hahn, 19781. Among the methods used, microwaves are considered to be especially useful for obtaining efficient, well-controlled heating of certain tumors [Hornback et al, 1977;Johnson et al, 1979;Gaboriaud et al, 19811. However, more information about possible specific biological effects produced by microwaves is needed to optimize the therapeutic effects of microwave-induced hyperthermia.…”

Section: Introductionmentioning

confidence: 99%

Thermal action of 2.45 GHz microwaves on the cytoplasm of Chinese hamster cells

Dardalhon

Moré²,

Averbeck

et al. 1984

Bioelectromagnetics

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In order to demonstrate possible specific effects of microwaves at the cellular level V-79 Chinese hamster cells were exposed to 2.45-GHz radiation at power levels of 20-200 mW/cm2 and at specific absorption rates of 10-100 mW/g. Intracellular cytoplasmic changes were observed by fluorescence polarization using a method based on the intracellular enzymatic hydrolysis of nonfluorescent fluorescein diacetate (FDA). At levels of absorbed energy below 90 J/g, modifications of microviscosity and mitochondrial state were absent, but a slight stimulation of enzymatic hydrolysis of FDA was observed which may be explained by microwave-induced alterations of cellular membranes possibly due to differences in heating pattern of microwaves compared to water-bath heating. At levels of absorbed energy above 90 J/g, the decrease of enzymatic hydrolysis of FDA, increase in degree of polarization, and increase of permeation of the fluorescent marker correlated well with the decrease in cell viability as measured by the exclusion of trypan blue. At equal absorbed energy, microwaves were found to exert effects comparable to classical heating except that permeation was slightly more affected by microwave than by classical heating. This suggests that membrane alteration produced by microwaves might differ from those induced by classical heating or that microwaves may have heated the membrane to higher temperatures than did classical heating.

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Fractionated radiation and hyperthermia: Experimental and clinical studies

Overgaard

1981

Cancer

113

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The effect of fractionated radiation and hyperthermia was experimentally studied in a C3H mammary carcinoma and its surrounding skin. Simultaneous radiation and heat (42.5 C-60 minutes) with one or five fractions gave thermal enhancement ratios (TER) of approximately 2.5 in both tumor and surrounding skin, and no improved therapeutic effect was obtained. Five fractions of sequential treatment with heating four hours after radiation reduced the tumor TER to about 1.4, but when 72 hours were allowed between the fractions, no thermal enhancement of the skin was observed. Thus, an improved therapeutic ratio was observed. Clinically the combined treatment was studied in 12 patients with 49 metastases from malignant melanoma treated with different schedules of radiation and hyperthermia (approximately 43 C for 30 minutes). Simultaneous treatment with three fractions in eight days gave TER values in the skin between 1.2-1.4, but a similar effect was found in the tumor. Three fractions of sequential treatment in eight days did not produce any thermal enhancement of the skin response, but still presented an apparent gain of the tumor response, and so seemed to increase the therapeutic effect. Bases on these findings, the strategy for further clinical use of combined hyperthermia and radiation is discussed.

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A pilot study to investigate skin and tumor thermal enhancement ratios of 41.5–42.0°c hyperthermia with radiation

Cited by 25 publications

References 10 publications

Re-setting the biologic rationale for thermal therapy

Re-setting the biologic rationale for thermal therapy

Thermal action of 2.45 GHz microwaves on the cytoplasm of Chinese hamster cells

Fractionated radiation and hyperthermia: Experimental and clinical studies

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