title: Randomised trial of hyperthermia as adjuvant to radiotherapy for recurrent or metastatic malignant melanoma. European Society for Hyperthermic Oncology.
abstract: The value of hyperthermia as an adjuvant to radiotherapy in patients with malignant melanoma was studied in a European multicentre trial. 134 metastatic or recurrent lesions of malignant melanoma in 70 patients were randomly assigned to receive radiotherapy (three fractions of 8 Gy or 9 Gy in 8 days) alone or followed by hyperthermia (43 degrees C for 60 min). Overall, the 2-year actuarial local tumour control was 37 (SE 5)%. Univariate analysis showed a beneficial effect of hyperthermia (radiation alone 28% vs combined treatment 46%, p = 0.008) and radiation dose (24 Gy 25% vs 27 Gy 56%, p = 0.02), but no effect of tumour size (< or = 4 cm 42% vs > 4 cm 29%, p = 0.21). Cox multivariate regression analysis showed the most important prognostic variables to be hyperthermia (odds ratio for 2-year local control 1.73 [95% CI 1.07-2.78], p = 0.023), tumour size (0.91 [0.85-0.99], p = 0.05), and radiation dose (1.17 [1.01-1.36], p = 0.05). Addition of heat did not significantly increase acute or late radiation reactions. Heating was well tolerated, but because of difficulties with equipment only 14% of treatments achieved the protocol objective. The overall 5-year survival rate was 19%, but 38% of the patients for whom all known disease was controlled survived 5 years. Adjuvant hyperthermia significantly improved local tumour control when applied in association with radiation in treatment of malignant melanoma. Successful local treatment of patients with a single or a few metastatic malignant melanoma lesions has significant curative potential.
authors.affiliation: Danish Cancer Society Department of Experimental Clinical Oncology, Aarhus.
authors.forename: J
authors.initials: J
authors.lastname: Overgaard
authors.forename: D
authors.initials: D
authors.lastname: Gonzalez Gonzalez
authors.forename: M C
authors.initials: MC
authors.lastname: Hulshof
authors.forename: G
authors.initials: G
authors.lastname: Arcangeli
authors.forename: O
authors.initials: O
authors.lastname: Dahl
authors.forename: O
authors.initials: O
authors.lastname: Mella
authors.forename: S M
authors.initials: SM
authors.lastname: Bentzen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary / Q000628:therapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy / Q000628:therapy; D011379:Prognosis; D012044:Regression Analysis; D012878:Skin Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome