Whole body hyperthermia: a secure procedure for patients with various malignancies?

Kerner, Thoralf; Deja, Maria; Ahlers, Olaf; Löffel, J; Hildebrandt, Bert; Wust, Peter; Gerlach, Herwig; Riess, Hanno

doi:10.1007/s001340050989

Cited by 37 publications

(34 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Therapeutic whole body hyperthermia (WBH) with body core temperatures up to 42.2°C, which is used for the treatment of patients with disseminated malignancies, has been demonstrated to be feasible with acceptable toxicity when radiant heat devices are employed Hildebrandt et al 2005;Kerner et al 1999;Wust et al 2002). In contrast to the locoregional hyperthermia approaches, its clinical efficacy has not been proven in the scope of randomised trials yet.…”

Section: Introductionmentioning

confidence: 99%

“…Application of therapeutic WBH is associated with extreme acute stress reactions, indicated by significant increase of heart rate, cardiac output and oxygen consumption (Berry et al 1997;Faithfull et al 1984;Kerner et al 1999). In addition, elevated plasma levels of stress hormones have been observed under hyperthermic conditions (Kappel et al 1991;Kearns et al 1999;Robins et al 1987) and suppressive effects of these stress hormones on lymphocyte subpopulations as well as associated cytokines are well known (Elenkov and Chrousos 2002;Iwakabe et al 1998;Kohm and Sanders 2001;Madden et al 1995).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Stress induced changes in lymphocyte subpopulations and associated cytokines during whole body hyperthermia of 41.8–42.2°C

et al. 2005

View full text Add to dashboard Cite

Extreme acute physical stress leads to transient impairment of T-lymphocytes, which are essential for tumor defence and prevention of infectious diseases. Radiant whole body hyperthermia (WBH) at 41.8-42.2 degrees C may enhance the efficacy of systemic chemotherapy in patients with advanced malignancies, but is associated with marked physical stress. Aim of this study was to demonstrate stress induced short-time effects on lymphocyte subpopulations and associated cytokines during WBH. Total leukocyte count, white blood cell differential blood count, lymphocyte subpopulations (T-helper-/T4-cells, T-suppressor-/T8-cells, natural-killer-/NK-cells, gammadelta-T-cells) as well as plasma levels of Interleukin(IL)-10, IL-12 and Interferon-gamma (IFN-gamma) were measured in ten patients treated with WBH and additional cytostatic chemotherapy. Blood samples were drawn before treatment, at three temperature points during WBH, and 24 h after start of treatment. Results were compared with those obtained from a control group consisting of six patients receiving chemotherapy alone. Numbers of T4-cells decreased significantly during WBH, while numbers of NK-cells and gammadelta-T-cells increased, resulting in transient impairments of total lymphocyte counts and T4/T8-ratio. IL-12 plasma levels as well as IFN-gamma/IL-10-ratio also decreased during WBH. No significant changes were found in T8-cells of WBH patients. Changes were reversible within 24 h and could not been found in control patients. Our results support the hypothesis that WBH combined with chemo therapy induces a strong but reversible anti-inflammatory stress response in cancer patients during therapy. Further studies are necessary to examine the pathophysiological details and to evaluate the meaning of these transient immunological changes for patient's outcome.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Stress induced changes in lymphocyte subpopulations and associated cytokines during whole body hyperthermia of 41.8–42.2°C

et al. 2005

View full text Add to dashboard Cite

show abstract

“…Furthermore, some chemotherapeutic agents are cardiotoxic and WBH can have adverse effects on the cardiopulmonary system [3][4][5][6]. Therefore, intensive monitoring during this procedure is required in order to detect and treat hemodynamic complications as soon as possible.…”

Section: Introductionmentioning

confidence: 99%

Monitoring of whole-body hyperthermia with transesophageal echocardiography (TEE)

Fippel¹,

Sandersleben

Bangert

et al. 2007

International Journal of Hyperthermia

View full text Add to dashboard Cite

show abstract

“…The whole body hyperthermia technique that raises core body temperature to 399 C, even to 429 C, has also been successfully introduced in clinics. 7,8,11,15) The duration of vecuronium bromide in the case of intra-abdominal high temperature thermal therapy is obviously shortened compared to non-thermal therapy (shortened from 46.2 min to 28.2 min). 1) Thus, iMR imaging could trigger a rise in core body temperature and shorten the duration of clinical action and recovery index of the vecuronium bromide.…”

Section: Discussionmentioning

confidence: 99%

Effects of Intraoperative Magnetic Resonance Imaging on the Neuromuscular Blockade of Vecuronium Bromide in Neurosurgery

Guo

Zhang

Sun

2013

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

The effects of intraoperative magnetic resonance (iMR) imaging on the neuromuscular blockade of vecuronium bromide were investigated in neurosurgery. Fifty patients with American Society of Anesthesiologists grades I-II scheduled for craniotomy operation were divided into two groups (n ＝ 25 each) with no difference in demographic data: the iMR imaging group and control group. Train-of-four (TOF) stimulation through an accelerometer was used to monitor onset, maintenance, and recovery of muscle relaxation caused by vecuronium. Vecuronium bromide was intravenously injected after anesthesia induction. The dosage of vecuronium bromide in the iMR imaging group was larger than in the control group, but not significantly. Duration of vecuronium bromide administration and operation time were significantly longer in the iMR imaging group than in the control group. Time from drug discontinuation to operation termination, and to return to neurosurgery intensive care unit were not different. Time taken by first twitch (T 1 ) in response to TOF stimulation to recover by 25%, and muscle relaxant recovery index were significantly greater in the control group than in the iMR imaging group. The body temperature of the patients increased gradually in the iMR imaging group but decreased in the control group. iMR imaging can prolong the operation time, increase the body temperature of the patient, and remarkably shorten the clinical action time and muscle relaxation recovery index of vecuronium.

show abstract

Whole body hyperthermia: a secure procedure for patients with various malignancies?

Abstract: sCMT, including whole body hyperthermia, accompanied by suitable anesthesiological management and monitoring, does not lead to any serious or sustained organ dysfunction and can therefore be regarded as a safe therapy.

Cited by 37 publications

References 15 publications

Stress induced changes in lymphocyte subpopulations and associated cytokines during whole body hyperthermia of 41.8–42.2°C

Stress induced changes in lymphocyte subpopulations and associated cytokines during whole body hyperthermia of 41.8–42.2°C

Monitoring of whole-body hyperthermia with transesophageal echocardiography (TEE)

Effects of Intraoperative Magnetic Resonance Imaging on the Neuromuscular Blockade of Vecuronium Bromide in Neurosurgery

Contact Info

Product

Resources

About