Intra-arterial and Systemic Chemotherapy plus External Hyperthermia in Unresectable Biliary Cancer

Mambrini, Andrea; Freo, A. Del; Pacetti, Paola; Orlandi, M.; Torri, T; Fiorentini, Giammaria; Cantore, Maurizio

doi:10.1016/j.clon.2007.08.013

Cited by 8 publications

(5 citation statements)

References 6 publications

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“…Recent investigations (7-10) have focused on the application of thermal energy to enhance chemotherapy for a variety of malignancies. For cholangiocarcinoma, thermal chemotherapy is achieved by means of either whole-body hyperthermia or external hyperthermia around the liver (11,12). Because of the deep anatomic location of a bile cancer, it is difficult to generate highly focused hyperthermia at the target tumor by using systemic or external hyperthermia.…”

Section: Methodsmentioning

confidence: 99%

Intrabiliary RF Heat-enhanced Local Chemotherapy of a Cholangiocarcinoma Cell Line: Monitoring with Dual-Modality Imaging—Preclinical Study

Zhang¹,

Le²,

Wu³

et al. 2014

Radiology

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Purpose:To determine whether magnetic resonance (MR) imaging heating guidewire-mediated radiofrequency (RF) hyperthermia could enhance the therapeutic effect of gemcitabine and 5-fluorouracil (5-FU) in a cholangiocarcinoma cell line and local deposit doses of chemotherapeutic drugs in swine common bile duct (CBD) walls. Materials and Methods:The animal protocol was approved by the institutional animal care and use committee. Green fluorescent proteinlabeled human cholangiocarcinoma cells and cholangiocarcinomas in 24 mice were treated with (a) combination therapy with chemotherapy (gemcitabine and 5-FU) plus RF hyperthermia, (b) chemotherapy only, (c) RF hyperthermia only, or (d) phosphate-buffered saline. Cell proliferation was quantified, and tumor changes over time were monitored with 14.0-T MR imaging and optical imaging.To enable further validation of technical feasibility, intrabiliary local delivery of gemcitabine and 5-FU was performed by using a microporous balloon with (eight pigs) or without (eight pigs) RF hyperthermia. Chemotherapy deposit doses in the bile duct walls were quantified by means of high-pressure liquid chromatography. The nonparametric Mann-Whitney U test and the paired-sample Wilcoxon signed rank test were used for data analysis. Results:Combination therapy induced lower mean levels of cell proliferation than chemotherapy only and RF hyperthermia only (0.39 6 0.13 [standard deviation] vs 0.87 6 0.10 and 1.03 6 0.13, P , .001). Combination therapy resulted in smaller relative tumor volume than chemotherapy only and RF hyperthermia only (0.65 6 0.03 vs 1.30 6 0.021 and 1.37 6 0.05, P = .001). Only in the combination therapy group did both MR imaging and optical imaging show substantial decreases in apparent diffusion coefficients and fluorescent signals in tumor masses immediately after the treatments. Chemotherapy quantification showed a higher average drug deposit dose in swine CBD walls with intrabiliary RF hyperthermia than without it (gemcitabine: 0.32 mg/g of tissue 6 0.033 vs 0.260 mg/g 6 0.030 and 5-FU: 0.660 mg/g 6 0.060 vs 0.52 mg/g 6 0.050, P , .05). Conclusion:The use of intrabiliary MR imaging heating guidewiremediated RF hyperthermia can enhance the chemotherapeutic effect on a human cholangiocarcinoma cell line and local drug deposition in swine CBD tissues.q RSNA, 2013

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Section: Methodsmentioning

confidence: 99%

Intrabiliary RF Heat-enhanced Local Chemotherapy of a Cholangiocarcinoma Cell Line: Monitoring with Dual-Modality Imaging—Preclinical Study

Zhang¹,

Le²,

Wu³

et al. 2014

Radiology

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“…fewer tumor related symptoms) and laboratory results were reported in a detailed case report of a patient with unresectable hilar CCC[ 75 ]. Similarly, extending hepatic arterial infusion chemotherapy with hyperthermia in patients with advanced BC have resulted in longer progression-free and overall survival and in better disease control rate[ 45 , 46 ] (Figures 2 and 3 ). The positive effects of hyperthermia were observed after the first few treatments[ 46 ], complete responses have been reported[ 46 ], and no increased toxicity after chemotherapy occurred[ 45 ].…”

Section: Hyperthermia In Biliary Tract Cancersmentioning

confidence: 99%

Evidence based tools to improve efficiency of currently administered oncotherapies for tumors of the hepatopancreatobiliary system

Herold

Szász

Dank

2021

WJGO

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Hepatopancreatobiliary tumors are challenging to treat, and the advanced or metastatic forms have a very low 5-year survival rate. Several drug combinations have been tested, and new therapeutic approaches have been introduced in the last decades, including radiofrequency and heat based methods. Hyperthermia is the artificial heating of tumors by various biophysical methods that may possess immunostimulant, tumoricidal, and chemoradiotherapy sensitizer effects. Both whole-body and regional hyperthermia studies have been conducted since the 1980s after the introduction of deep-seated tumor hyperthermia techniques. Results of the effects of hyperthermia in hepatocellular and pancreatic cancer are known from several studies. Hyperthermia in biliary cancers is a less investigated area. High local and overall responses to treatment, increased progression-free and overall survival, and improved laboratory and quality-of-life results are associated with hyperthermia in all three tumor types. With the evolution of chemotherapeutic agents and the introduction of newer techniques, the combination of adjuvant hyperthermia with those therapies is advantageous and has not been associated with an increase in alarming adverse effects. However, despite the many positive effects of hyperthermia, its use is still only known at the experimental level, and its concomitant utilization in routine cancer treatment is not certain because of the lack of thorough clinical studies.

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“…In the case of etoposide, cytotoxicity was even reduced, which was explained by instability of the drug at an increased temperature. Whether the clinical combination of HT and ChT leads to therapeutic gain depends on the temperature increase in the organs for which the used drug is toxic and the heating method [59,60,61,62,63,64,65,66,67,68,69,70,71].…”

Section: Chemotherapy Plus Hyperthermiamentioning

confidence: 99%

Thermoradiotheraphy for cancer: an effective approach

Fatehi¹,

Zee²,

Rhoon³

2008

amj

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Hyperthermia (HT) means using controlled temperatures of 40-45°C for cancer treatment. HT is applied with different methods e.g. superficial-HT, locoregional deep-HT, interstitial-HT, intracavity-HT, and whole body-HT. HT can apply in different tumor sites such as breast cancer, melanoma, head and neck, cervix cancer, and glioblastoma. Literatures show that addition of HT to radiotherapy, chemotherapy, or both, will result better tumor response rate, local control, and survival rate; without increasing toxicity. HT can also improve palliative effects in patient. In recent years, due to substantial technical improvements made in achieving selected increase of temperatures in superficial and deep-seated tumors, thermometry, and treatment planning; HT is becoming more clinically accepted in Europe and the USA. HT, as an adjunct cancer treatment modality, is certainly a promising approach; however, it is not well known yet worldwide. Therefore, it seems there is need to know more about that. The purpose of this review is to provide an overview on the application of HT combined with conventional cancer treatment modalities, mainly radiotherapy. The article also introduces mechanism of HT, heating delivery modes, thermometry, and it summarizes results of randomized trials form Western research groups.

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Intra-arterial and Systemic Chemotherapy plus External Hyperthermia in Unresectable Biliary Cancer

Cited by 8 publications

References 6 publications

Intrabiliary RF Heat-enhanced Local Chemotherapy of a Cholangiocarcinoma Cell Line: Monitoring with Dual-Modality Imaging—Preclinical Study

Intrabiliary RF Heat-enhanced Local Chemotherapy of a Cholangiocarcinoma Cell Line: Monitoring with Dual-Modality Imaging—Preclinical Study

Evidence based tools to improve efficiency of currently administered oncotherapies for tumors of the hepatopancreatobiliary system

Thermoradiotheraphy for cancer: an effective approach

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