Phase II trial of combined regional hyperthermia and gemcitabine for locally advanced or metastatic pancreatic cancer

Ishikawa, Takeshi; Kokura, Satoshi; Sakamoto, Naoyuki; Ando, Takashi; Imamoto, Eiko; Hattori, Takeshi; Oyamada, Hirokazu; Yoshinami, Naomi; Sakamoto, Masafumi; Kitagawa, Kazutomo; Okumura, Yoko; Yoshida, Naohisa; Kamada, Kazuhiro; Katada, Kazuhiro; Uchiyama, Kazuhiko; Handa, Osamu; Takagi, Tomohisa; Yasuda, Hiroaki; Sato, Junichi; Konishi, Hideyuki; Yagi, Nobuaki; Naito, Yuji; Yoshikawa, Toshikazu

doi:10.3109/02656736.2012.695428

Cited by 41 publications

(36 citation statements)

References 29 publications

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“…In GEM chemotherapy, nuclear factor kappa B (NF-κB), a transcription factor, is activated through immunological mechanisms, and this is regarded as one of the causes of GEM resistance development. Heat shock protein induced by concurrent HCR reportedly exerts inhibitory actions on NF-κB activity (18,19), which is regarded as being a mechanism underlying the antitumor effect of HCR. Accordingly, for patients whose performance status is satisfactory, hyperthermia is considered to contribute to prolonged survival Figure 2.…”

Section: Discussionmentioning

confidence: 99%

Treatment outcomes of concurrent hyperthermia and chemoradiotherapy for pancreatic cancer: Insights into the significance of hyperthermia treatment

et al. 2017

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Abstract.Patients with locally advanced unresectable pancreatic cancer (LAUPC) have a poor prognosis. In addition their quality of life impaired by cancer pain and biliary tract infections. Therefore, multimodality therapy and selection of optimal treatment methods are essential for achieving prolonged survival. The present study investigated the significance of using hyperthermia concurrently with multimodality therapy to improve treatment outcomes in patients with LAUPC. In total, 13 patients receiving concurrent hyperthermia and chemoradiotherapy (HCR) or chemoradiotherapy (CR) alone for LAUPC between 2002 and 2013 were analyzed retrospectively. Of the 13 patients, 5 received concurrent HCR and 8 received CR. The chemotherapy regimens were 5-fluorouracil (5-FU) in 5 patients and gemcitabine hydrochloride (GEM) in the other 8. Patients who gave consent for hyperthermia treatment received GEM plus CR. The median overall survival period for all patients was 12 months and the 1-year survival rate was 55%; the corresponding values were 12 months and 57% in the GEM CR group, and 15 months and 80% in the HCR group. Univariate analyses was perfomed to identify factors predicting recurrence after treatment. The potential prognostic factors analyzed were: Age, sex, performance status, location, tumor size, the tumor marker CA 19-9, total radiation dose, chemotherapy and hyperthermia. Univariate analysis for factors associated with outcomes revealed a significant difference favoring the HCR group [relative risk=15.97 (95% confidence interval: 12.87-19.83) P=0.021]. In conclusion, hyperthermia merits active recommendation to pancreatic cancer patients who have a positive attitude toward this treatment and whose performance status is satisfactory.

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Section: Discussionmentioning

confidence: 99%

Treatment outcomes of concurrent hyperthermia and chemoradiotherapy for pancreatic cancer: Insights into the significance of hyperthermia treatment

et al. 2017

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“…Ishikawa et al [63] 18 None c-LRHT (40 min.) bring the temperature below the required temperature, as reported by Yamada et al [54]; although their target temperature was 42.5 C, only in five of the 17 patients the tumour was heated to more than the required 42 C. In this review, only one subcutaneous fatty burn was reported in one patient.…”

Section: Thermal Dosimetrymentioning

confidence: 99%

“…Locoregional hyperthermia was used in eight studies, with heating of tumour and surrounding tissue either radiative (using radiofrequency waves; 63 patients) [62,64] or capacitive (using electrodes; 126 patients) [53,58,60,63,65,66]. Treatment times varied from 40-60 min.…”

Section: Patient Characteristics and Treatment Regimensmentioning

confidence: 99%

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The clinical benefit of hyperthermia in pancreatic cancer: a systematic review

Horst

Versteijne

Besselink

et al. 2017

International Journal of Hyperthermia

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Objective: In pancreatic cancer, which is therapy resistant due to its hypoxic microenvironment, hyperthermia may enhance the effect of radio(chemo)therapy. The aim of this systematic review is to investigate the validity of the hypothesis that hyperthermia added to radiotherapy and/or chemotherapy improves treatment outcome for pancreatic cancer patients. Methods and materials: We searched MEDLINE and Embase, supplemented by handsearching, for clinical studies involving hyperthermia in pancreatic cancer patients. The quality of studies was evaluated using the Oxford Centre for Evidence-Based Medicine levels of evidence. Primary outcome was treatment efficacy; we calculated overall response rate and the weighted estimate of the population median overall survival (m p ) and compared these between hyperthermia and control cohorts. Results: Overall, 14 studies were included, with 395 patients with locally advanced and/or metastatic pancreatic cancer of whom 248 received hyperthermia. Patients were treated with regional (n ¼ 189), intraoperative (n ¼ 39) or whole-body hyperthermia (n ¼ 20), combined with chemotherapy, radiotherapy or both. Quality of the studies was low, with level of evidence 3 (five studies) and 4. The six studies including a control group showed a longer m p in the hyperthermia groups than in the control groups (11.7 vs. 5.6 months). Overall response rate, reported in three studies with a control group, was also better for the hyperthermia groups (43.9% vs. 35.3%). Conclusions: Hyperthermia, when added to chemotherapy and/or radiotherapy, may positively affect treatment outcome for patients with pancreatic cancer. However, the quality of the reviewed studies was limited and future randomised controlled trials are needed to establish efficacy. ARTICLE HISTORY

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“…The Japanese Trial (Ishikawa et al 2012) [32] Patients were administered gemcitabine 1,000 mg/m2 on days 1, 8 and 15 every 4 weeks. Loco-regional hyperthermia (capacitative system) was delivered once per week, a day preceding the gemcitabine infusion.…”

Section: The German Study I (Hager Et Al 2006) [24]mentioning

confidence: 99%

Review: The Role of Hyperthermia in Treating Pancreatic Tumors

Roesch

Mueller-Huebenthal

2014

Indian J Surg Oncol

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There is only marginal improvement in outcome of treating pancreatic cancer in the last two decades. Time to open up and have a fresh look at complementary adjuvant treatment options. Hyperthermia may be one such option. Hyperthermic intraperitoneal chemotherapy (HIPEC) predominantly as a intrasurgical procedure has already proved its justification. Non-invasive loco regional hyperthermia as complement to either chemo or radiation has not yet reached a comparable status of evidence. However the potential to eventually grow into such evidence is already clearly observable. This review presents the various methodologies available for hyperthermia, covers the initial clinical data that has been published and gives an outlook to what can be expected in the next 2-3 years to come. Hyperthermia has the potential to significantly prolong life expectancies and this while maintaining a satisfying quality of life!

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Phase II trial of combined regional hyperthermia and gemcitabine for locally advanced or metastatic pancreatic cancer

Abstract: Regional hyperthermia combined with gemcitabine is well tolerated and active in patients with locally advanced pancreatic cancer.

Cited by 41 publications

References 29 publications

Treatment outcomes of concurrent hyperthermia and chemoradiotherapy for pancreatic cancer: Insights into the significance of hyperthermia treatment

Treatment outcomes of concurrent hyperthermia and chemoradiotherapy for pancreatic cancer: Insights into the significance of hyperthermia treatment

The clinical benefit of hyperthermia in pancreatic cancer: a systematic review

Review: The Role of Hyperthermia in Treating Pancreatic Tumors

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