Whole body hyperthermia in adjuvant therapy of children with renal cell carcinoma

Abstract

Whole body hyperthermia (WBH) in combination with chemotherapy has been proven to be effective in some patients with advanced malignancies. However, only limited experience exists regarding the application of WBH with chemotherapy in children. We present the results of applying WBH and chemotherapy in five children with advanced renal cell carcinoma (RCC). WBH (3 hr, 41.8-42.5 degrees C) combined with doxorubicin (50 mg/m2) and interferon-alpha (3 MU/m2) were applied to patients after nephrectomy and lymph node dissection. Each patient received three to eight courses of treatment three times weekly. All children tolerated the combined therapy well without complications. Follow-up of 7-68 months (median: 22 months) showed no tumor progression in patients with locoregional (n = 3) and metastatic (n = 2) disease. WBH with moderate dose doxorubicin and INF-alpha might be a feasible treatment option in childhood RCC.

Pediatric renal cell carcinoma

“…Nonetheless, there are multiple case reports of adjuvant therapy for distant metastatic disease. IsmailZade and colleagues [42] reported that a regimen of whole body hyperthermia, doxorubicin, and interferon alpha (IFNa) was tolerated by five patients, two of whom had metastatic RCC; survival in the Mþ patients was 100% with a mean follow up of 12 months. Complete responses of pediatric RCC to high dose IL-2 have been reported [43].…”

Thermal Therapy, Part 2: Hyperthermia Techniques

“…Improvement of local control by hyperthermia combined with systemic chemotherapy was observed by many researchers. [309][310][311][312][313][314][315][316][317][318][319] There is insufficient information to make conclusions regarding the use of WBH as an adjunct to either radiation or chemotherapy, and inadequate data regarding the use of local hyperthermia in conjunction with chemotherapy alone. This practice is based, in part, on an initial body of evidence consisting of phase I and II clinical studies describing the technical feasibility of WBH.…”

Metastatic renal cell carcinoma kidney in children 10 years old – possibility of targeted therapy

“…-3-летний опыт лечения ПКР с метастатическим поражением у 14 пациентов; R. S. Ismail-zade и соавт. -способ ле-чения ПКР с помощью гипертермии у 5 детей, среди которых 2 пациента имели метастатическое пораже-ние [3,[5][6][7].…”

“…-3-летний опыт лечения ПКР с метастатическим поражением у 14 пациентов; R. S. Ismail-zade и соавт. -способ ле-чения ПКР с помощью гипертермии у 5 детей, среди которых 2 пациента имели метастатическое пораже-ние [3,[5][6][7].Данное заболевание в равной степени встречает-ся у детей обоих полов [8], в отличие от взрослых, у которых оно преобладает у мужчин. Наиболее рас-пространенные формы проявления ПКР у детей -макрогематурия и боль в боку, менее частые симпто-мы -синдром пальпируемой опухоли в брюшной полости, анемия и лихорадка [4,8].…”

“…По данным мировой литературы, 85 % рецидивов, как правило, развиваются в течение первых 3 лет после установления диагноза [9], однако поздние рецидивы также не редки [2]. У детей это заболевание имеет ме-нее агрессивное течение, чем у взрослых [4,7]. …”