[Tumor oxygenation in combined whole body hyperthermia and polychemotherapy. Studies exemplified by recurrent carcinoma of the mouth cavity].
OBJECTIVE
Previous studies have reported synergistic effects of combined hyperthermia and chemotherapy and/or irradiation. The response to irradiation and chemotherapy of well-oxygenated and vascularized tumors generally is better than that of hypoxic tumors. Therefore, tumor oxygenation is recognized as an important predictive factor in the therapy of malignant tumors. In practice, the head and neck area remains outside of the hyperthermia chamber during whole-body hyperthermia. It was the aim of this study to evaluate if the head and neck region receives sufficient warmth and, if so, if tumor oxygenation increases accordingly.


METHODS
Whole-body hyperthermia, as heat radiation (Enthermics Medical Systems RHS-7500), was applied to the narcotised 60-year-old male patient with a local recurrence tumor pT3 pN2b M0 squamous cell carcinoma of the oral cavity. Tumor oxygenation and temperature were measured by LICOX catheters via one-point measurement during the entire hyperthermia treatment (3.5 h). Parallelly, chemotherapy (ifosfamide/Carboplatin) was given in four cycles (one cycle/month).


RESULTS
With a latency of 10 min the increase of intratumoral temperature was comparable to temperatures achieved in the esophagus. The maximum intratumoral temperature was 41.8 degrees C. The average increase in tumor oxygenation was more than 100%. The clinical outcome in the case presented was a partial tumor remission (PR).


CONCLUSIONS
During combined whole-body hyperthermia and polychemotherapy, tumor oxygenation is also significantly improved in the head and neck area, despite the fact that the head and neck area remained outside the hyperthermia chamber. The intratumoral temperature was comparable to esophageal and rectal temperatures.
Sagowski
C
C
Universitätsklinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, Kopf- und Halschirurgie, Universitätskrankenhaus Eppendorf, Universität Hamburg. christoph.sagowski@gmx.de
Kehrl
W
W
Hegewisch-Becker
S
S
Wenzel
S
S
Jaehne
M
M
Panse
J
J
Nierhaus
A
A
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000098:blood supply* / Q000188:drug therapy / Q000473:pathology; D015687:Cell Hypoxia / Q000187:drug effects / Q000502:physiology*; D003131:Combined Modality Therapy; D006801:Humans; D006979:Hyperthermia, Induced / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000098:blood supply* / Q000188:drug therapy / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000098:blood supply* / Q000188:drug therapy / Q000473:pathology; D009367:Neoplasm Staging
Tumoroxygenierung unter kombinierter Ganzkörperhyperthermie und Polychemotherapie. Untersuchungen am Beispiel eines Rezidivkarzinoms der Mundhöhle.