Integrating Hyperthermia into Modern Radiation Oncology: What Evidence Is Necessary?

Abstract

Hyperthermia (HT) is one of the hot topics that have been discussed over decades. However, it never made its way into primetime. The basic biological rationale of heat to enhance the effect of radiation, chemotherapeutic agents, and immunotherapy is evident. Preclinical work has confirmed this effect. HT may trigger changes in perfusion and oxygenation as well as inhibition of DNA repair mechanisms. Moreover, there is evidence for immune stimulation and the induction of systemic immune responses. Despite the increasing number of solid clinical studies, only few centers have included this adjuvant treatment into their repertoire. Over the years, abundant prospective and randomized clinical data have emerged demonstrating a clear benefit of combined HT and radiotherapy for multiple entities such as superficial breast cancer recurrences, cervix carcinoma, or cancers of the head and neck. Regarding less investigated indications, the existing data are promising and more clinical trials are currently recruiting patients. How do we proceed from here? Preclinical evidence is present. Multiple indications benefit from additional HT in the clinical setting. This article summarizes the present evidence and develops ideas for future research.

Biophysical and photobiological basics of water-filtered infrared-A hyperthermia of superficial tumors

“…At maximum skin surface temperatures of [42][43] C, the effective heating depth is 15 mm (!40 C) and 20 mm (!39.5 C), respectively. wIRA is a novel, approved and clinically effective technique [54].…”

Dependence of Ultrasonic and Magnetic Hyperthermia on the Concentration of Magnetic Nanoparticles

“…It induces heat in cancer tissues which leads to their weakening. Weaken cells are therefore more susceptible for other cancer therapies like radiotherapy or chemotherapy [1,2]. Heat in tissues can be induced by means of ultrasonic waves, alternating magnetic field, radiowaves or microwaves [3].…”

Rescue Therapy in Patient with NSCLC with the Combination of Chemotherapy and Hyperthermia

“…The patient arrived at my observation in April 2016 after a CT evaluation in March 2016 that showed the presence of multiple micro nodules in both lung fields of repetitive significance. Treatment was administered in chemotherapy with docetaxel [4] concomitant with deep capacitive hyperthermia at radio frequency [5,6]. Treatment was hesitant in disease stabilization until October 2016.…”

“…After a massive new metastasis, it was decided for a fifth therapeutic rescue line with a combination of nab-paclitaxel [8] with a weekly dose of 100 mg/m 2 , a daily dose of 100 mg temozolomide [9] from the first to fifth day of the week, epirubicin [10,11] at 25 mg/m 2 weekly. In addition, deep capacitive radio frequency capacitive hyperthermia applications with alternating days of single duration of 55 minutes [5,6,12]. After two months, a CT test showed partial response with disease reduction and improvement of symptomatology (mainly dyspnoea).…”