[Standards and perspectives in locoregional hyperthermia].
The term "hyperthermia" summarises different procedures of raising the temperature of a tumour-loaded tissue to a temperature of 40-43 degrees C. In this context, locoregional procedures (radiative/capacitive local, interstitial and regional hyperthermia; endoluminal hyperthermia), hyperthermic perfusion techniques (hyperthermic peritoneal and isolated limb perfusion), and whole-body hyperthermia differ with regard to their indication, expenditure of application, and evidence of efficacy. All hyperthermia techniques have in common that they have no sufficient antineoplastic activity alone in the temperature range below 43-45 degrees C, but act in a synergistic way with radiotherapy and certain cytotoxic drugs. 14 out of 18 published randomised trials on hyperthermia as an adjunct to standard radio- or chemotherapy refer to locoregional approaches. Particular progress has been made in regional radiofrequency hyperthermia, where novel multiantenna-applicators and their integration into MR-applicators ("hybrid-systems") have recently been introduced into clinical practice. In addition, combinations of hyperthermia with novel technologies (magnetic fluid hyperthermia, thermosensitive liposomes, immunotherapy, gene targeting) are imminent. We here give a critical update on the proven indications of the different locoregional hyperthermia approaches and on the current clinical and technological progress in this field.
Hildebrandt
Bert
B
Medizinische Klinik für Hämatologie und Onkologie, Campus Virchow Klinikum, Charitè Universitätsmedizin Berlin, Berlin, Deutschland. bert.hildebrandt@charite.de
Rau
Beate
B
Gellermann
Johanna
J
Kerner
Thoralf
T
Nicolaou
Annett
A
Blohmer
Jens-Uwe
JU
Trappe
Ralf Ulrich
RU
Riess
Hanno
H
Wust
Peter
P
D000970:Antineoplastic Agents / Q000627:therapeutic use; D010478:Chemotherapy, Cancer, Regional Perfusion; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004867:Equipment Design; D006801:Humans; D006979:Hyperthermia, Induced / Q000295:instrumentation / Q000592:standards*; D009369:Neoplasms / Q000473:pathology / Q000628:therapy*; D011878:Radiotherapy; D013696:Temperature; D013813:Therapy, Computer-Assisted / Q000295:instrumentation / Q000592:standards*; D016896:Treatment Outcome
D000970:Antineoplastic Agents