[Water-filtered infrared-A-hyperthermia combined with radiotherapy in advanced and recurrent tumors. Initial results of a multicenter phase I-II study].
BACKGROUND
Water-filtered infrared-A-radiation (IR/A-HT) can be used to heat superficial malignant tumors. A prospective multicenter phase I-II study was conducted to evaluate toxicity and efficacy of IR/A-HT combined with external beam radiotherapy (RT).


METHODS
From December 1991 to June 1994, a total of 53 patients with 58 malignant lesions were entered in the study. There were 14 primary, 36 recurrent and 8 metastatic tumors which were located in the head and neck region (14), chest wall (31), abdominal wall (2) and the extremities (11). The mean tumor volume was 100 cm3. IR/A-HT was applied 1 to 2 times per week with up to 3 IR/A-HT-radiators directly before or after external RT for 1 hour at 40.5 to 44 degrees C. Temperatures were controlled at various locations at the skin surface and invasively at depth.


RESULTS
IR/A-HT was well tolerated: in 31 (53%) lesions acute (pain, pulse or blood pressure changes, increased skin reaction etc.) and in 25 (43%) chronic side-effects (atrophy, telangiectasis, fibrosis etc.) were noted; usually the toxicity was minor and temporary. At 3 months FU, 32 (55%) lesions achieved a local CR and 19 (35%) a PR; at 12 months FU, 25 (43%) had persistent CR; 16 patients (18 lesions) were deceased and 3 (4 lesions) not yet in FU. In univariate analysis the following prognostic factors for CR at 3 or 12 months FU were found: Karnofsky, metastatic status, tumor size, total RT-dose, thermal parameters T min(av) and T mean. For acute toxicity maximum temperature Tmax(av) was prognostically decisive. Significant differences were also found when considering the "quality of the HT-application". The microwave technique was superior to the infrared-A-HT-technique with regard to the penetration depth of energy deposition.


CONCLUSIONS
Water-filtered infrared-A-radiation can be safely and effectively applied to heat localized superficial tumors (up to 1 cm depth). To increase the area of HT application multiple infrared-A-radiators have to be combined. A multi-element-system is in progress.
Seegenschmiedt
M H
MH
Klinik und Poliklinik für Strahlentherapie, Universität Erlangen-Nürnberg.
Klautke
G
G
Walther
E
E
Feldmann
H J
HJ
Katalinic
A
A
Stuschke
M
M
von Lieven
H
H
Vaupel
P
P
D000009:Abdominal Muscles; D000008:Abdominal Neoplasms / Q000532:radiotherapy / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000628:therapy; D003131:Combined Modality Therapy; D005121:Extremities; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000628:therapy; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects; D007259:Infrared Rays; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy / Q000628:therapy; D009369:Neoplasms / Q000532:radiotherapy* / Q000628:therapy*; D011379:Prognosis; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D013899:Thoracic Neoplasms / Q000532:radiotherapy / Q000628:therapy; D013997:Time Factors