All the completed randomised studies in this review were identified by searches of Medline. Additional continuing randomised trial are known from recent international conferences of the hyperthermia organisations (in particular the European Society of Hyperthermic Oncology). The phase II studies referenced are a collection personally weighted and known from the German Hyperthermia Organisation, where all German trials are listed, and further from international conferences of the European
ReviewHyperthermia in combined treatment of cancer
Section snippets
Methods to increase temperatures
To reach temperatures clearly above the systemic temperature of 37·5°C in a defined target volume is a technical challenge and still under development. The temperature increase is induced by applying a power-density specific absorption rate (SAR; measured in W/kg). Human basal metabolic rate (basal metabolism) is above 1 W/kg. Perfusion counteracts the temperature rise. Perfusion rates in human tumours are around 5–15 mL per 100 g per min, but they vary widely. To reach therapeutic temperatures
Clinical trials on hyperthermia
By searches of the Medline database, we identified 18 comparative, prospective phase III trials on different hyperthermia modalities up to March 2001 (table 1). In ten of these trials, external radiotherapy alone was compared with radiotherapy plus hyperthermia14, 38, 39, 40, 41, 42, 43, 44 or interstitial radiotherapy alone was compared with interstitial radiotherapy plus interstitial hyperthermia.45, 46 Only two studies on locoregional hyperthermia included chemotherapy.47, 48 In three trials
Conclusions
Recent clinical results give new insight into the mechanisms of hyperthermia in multimodal oncological treatments. Hyperthermia is thought to affect tumour sensitivity to other treatments mainly through microenvironmental factors such as pH. One hypothesis is that hypoxic and therefore resistant tumour regions are preferentially eliminated under hyperthermic conditions because associated hypovascularisation results in higher temperatures and higher sensitivity due to hypoxia. This assumption
Search strategy and selection criteria
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