Quality-assured local and regional hyperthermia procedures have been proven to enhance the clinical benefits of oncological standard treatments in several clinical settings, without a significant increase in late toxicity. This makes hyperthermia an attractive sensitizer for both radiotherapy and chemotherapy. During the past decade clinical evidence on the beneficial use of additive local and regional hyperthermia procedures as part of multimodality treatment approaches for several malignant diseases has increased significantly. Today, hyperthermia plays a role in the treatment of chest wall…mehr
Quality-assured local and regional hyperthermia procedures have been proven to enhance the clinical benefits of oncological standard treatments in several clinical settings, without a significant increase in late toxicity. This makes hyperthermia an attractive sensitizer for both radiotherapy and chemotherapy. During the past decade clinical evidence on the beneficial use of additive local and regional hyperthermia procedures as part of multimodality treatment approaches for several malignant diseases has increased significantly. Today, hyperthermia plays a role in the treatment of chest wall recurrences after breast cancer, locally advanced cervical cancer, locally advanced and recurrent rectal cancer, high risk soft tissue sarcoma, anal carcinoma and bladder cancer. It is no longer a question whether hyperthermia is an effective oncological treatment at all. Technical improvements in hyperthermia treatment quality assurance and delivery standards were summarized by a dedicated team of physicists, technicians and clinicians.This booklet is dedicated to the interested reader without any expertise in local and regional hyperthermia. It is designed to provide instant access with a focus on current and upcoming clinical research.
1.Principles of Hyperthermia131.1.Definition of Hyperthermia131.1.1.Different Temperature Regimes131.1.2.Heating Techniques141.1.3.References141.2.Physical Basics and Hyperthermia Applications141.2.1.Electromagnetic Irradiation141.2.2.Interaction of Non-Ionizing Electromagnetic Radiation with Matter161.2.3.Practical Realizations171.2.4.Planning and Optimization201.2.5.Harmful Effects of Non-Ionizing Radiation211.2.6.Further Heating Techniques211.2.7.Heat Transport221.2.8.References231.3.Biological Rationale of Hyperthermia231.3.1.Biological Rationale and Mode of Action of Hyperthermia231.3.2.Interaction of Hyperthermia and Chemotherapeutic Agents241.3.3.Interaction of Hyperthermia and Ionizing Radiotherapy241.3.4.Immune Modulation by Hyperthermia251.3.5.References262.Techniques, Clinical Use and Quality Assurance292.1.Hyperthermia Treatment Techniques292.1.1.Classical Techniques292.1.2.Recent Developments312.1.3.References332.2.Practical Recommendations352.2.1.Treatment Planning392.2.2.Treatment Monitoring412.2.3.Treatment Documentation422.2.4.Requirements and Characterization of Equipment422.2.5.Safety Aspects432.2.6.Hyperthermia Staff Requirements432.2.7.References432.3.Quality Assurance442.3.1.Heat Dosimetry442.3.2.The Hyperthermia QA Guidelines and Their Principles452.3.3.Thermometry and Verification472.3.5.Future Aspects482.3.6.References483.Clinical Results of Quality-Assured Hyperthermia513.1.Hyperthermia Alone513.2.Chemotherapy and Hyperthermia513.2.1.Peritoneal carcinomatosis of epithelial ovarian cancer (EOC)513.2.2.Non-muscle-invasive bladder cancer (NMIBC)523.2.3.High-risk soft tissue sarcomas (HR-STS) of adults533.2.4.Localized relapse or metastatic disease of soft-tissue sarcoma543.2.5.Pancreatic Cancer553.2.6.Breast Cancer563.2.7.Cervical Cancer563.2.8.Pedriatic Cancer563.2.9.References573.3.Radiotherapy and Hyperthermia593.3.1.Breast Cancer593.3.2.Rectal Cancer603.3.3.Cervical Carcinoma623.3.4.Further Results633.3.5.References633.4.Radiochemotherapy and Hyperthermia643.4.1.Breast Cancer643.4.2.Rectal Cancer643.4.3.Cervical Carcinoma653.4.4.Anal Cancer663.4.5.Bladder Cancer673.4.6.Esophageal Carcinoma683.4.7.Further Fields of Research693.4.8.References694.The Role of Hyperthermia in Pediatric Oncology714.1.Indications714.2.Locoregional Radiofrequency Hyperthermia in Children and Adolescents714.2.1.Application of Hyperthermia and Thermometry714.2.2.Analysis of Temperatures734.2.3.Hyper-PEI Treatment Schedule734.3.Limitations744.4.Results754.4.1.Experimental Studies754.4.2.Clinical Studies764.4.2.1.Radiofrequency Hyperthermia and Chemotherapy764.4.2.2.Radiofrequency Hyperthermia and Radiotherapy774.5.Technical Approach and Perspectives794.6.Surgical Techniques for Isolated Hyperthermic Perfusion with High-Dose Chemotherapy824.6.1.Isolated Hyperthermic Limb Perfusion824.6.2.Hyperthermic Intraperitoneal Chemoperfusion824.7.Clinical Aspects834.8.References845.Current and Future Clinical Trials875.1.Chemotherapy and Hyperthermia875.1.1.References905.2.Radiotherapy / Chemoradiation and Hyperthermia905.2.1.Anal Cancer905.2.2.Soft Tissue Sarcoma915.2.3.Rectal Cancer915.2.4.References926.Summary93Index95
1.Principles of Hyperthermia131.1.Definition of Hyperthermia131.1.1.Different Temperature Regimes131.1.2.Heating Techniques141.1.3.References141.2.Physical Basics and Hyperthermia Applications141.2.1.Electromagnetic Irradiation141.2.2.Interaction of Non-Ionizing Electromagnetic Radiation with Matter161.2.3.Practical Realizations171.2.4.Planning and Optimization201.2.5.Harmful Effects of Non-Ionizing Radiation211.2.6.Further Heating Techniques211.2.7.Heat Transport221.2.8.References231.3.Biological Rationale of Hyperthermia231.3.1.Biological Rationale and Mode of Action of Hyperthermia231.3.2.Interaction of Hyperthermia and Chemotherapeutic Agents241.3.3.Interaction of Hyperthermia and Ionizing Radiotherapy241.3.4.Immune Modulation by Hyperthermia251.3.5.References262.Techniques, Clinical Use and Quality Assurance292.1.Hyperthermia Treatment Techniques292.1.1.Classical Techniques292.1.2.Recent Developments312.1.3.References332.2.Practical Recommendations352.2.1.Treatment Planning392.2.2.Treatment Monitoring412.2.3.Treatment Documentation422.2.4.Requirements and Characterization of Equipment422.2.5.Safety Aspects432.2.6.Hyperthermia Staff Requirements432.2.7.References432.3.Quality Assurance442.3.1.Heat Dosimetry442.3.2.The Hyperthermia QA Guidelines and Their Principles452.3.3.Thermometry and Verification472.3.5.Future Aspects482.3.6.References483.Clinical Results of Quality-Assured Hyperthermia513.1.Hyperthermia Alone513.2.Chemotherapy and Hyperthermia513.2.1.Peritoneal carcinomatosis of epithelial ovarian cancer (EOC)513.2.2.Non-muscle-invasive bladder cancer (NMIBC)523.2.3.High-risk soft tissue sarcomas (HR-STS) of adults533.2.4.Localized relapse or metastatic disease of soft-tissue sarcoma543.2.5.Pancreatic Cancer553.2.6.Breast Cancer563.2.7.Cervical Cancer563.2.8.Pedriatic Cancer563.2.9.References573.3.Radiotherapy and Hyperthermia593.3.1.Breast Cancer593.3.2.Rectal Cancer603.3.3.Cervical Carcinoma623.3.4.Further Results633.3.5.References633.4.Radiochemotherapy and Hyperthermia643.4.1.Breast Cancer643.4.2.Rectal Cancer643.4.3.Cervical Carcinoma653.4.4.Anal Cancer663.4.5.Bladder Cancer673.4.6.Esophageal Carcinoma683.4.7.Further Fields of Research693.4.8.References694.The Role of Hyperthermia in Pediatric Oncology714.1.Indications714.2.Locoregional Radiofrequency Hyperthermia in Children and Adolescents714.2.1.Application of Hyperthermia and Thermometry714.2.2.Analysis of Temperatures734.2.3.Hyper-PEI Treatment Schedule734.3.Limitations744.4.Results754.4.1.Experimental Studies754.4.2.Clinical Studies764.4.2.1.Radiofrequency Hyperthermia and Chemotherapy764.4.2.2.Radiofrequency Hyperthermia and Radiotherapy774.5.Technical Approach and Perspectives794.6.Surgical Techniques for Isolated Hyperthermic Perfusion with High-Dose Chemotherapy824.6.1.Isolated Hyperthermic Limb Perfusion824.6.2.Hyperthermic Intraperitoneal Chemoperfusion824.7.Clinical Aspects834.8.References845.Current and Future Clinical Trials875.1.Chemotherapy and Hyperthermia875.1.1.References905.2.Radiotherapy / Chemoradiation and Hyperthermia905.2.1.Anal Cancer905.2.2.Soft Tissue Sarcoma915.2.3.Rectal Cancer915.2.4.References926.Summary93Index95
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