Whole body hyperthermia supplemented with urotropin in the treatment of malignant tumors.
OBJECTIVE
To evaluate the effect of urotropin on the tolerance of an extreme whole body hyperthermia (WBH) regime (44.5-45.0 degrees C for 60 min) in rats, and then its application to pediatric patients with advanced cancer during WBH sessions (42.5-43.0 degrees C).


METHODS
In experiments nonbred rats bearing Sarcoma 45 (Sa 45) were subjected to severe WBH with and without urotropin. Tolerance of WBH as well as tumor growth and survival of animals were monitored. Extreme WBH sessions (42.5-43.0 degrees C) + urotropin were used in multimodal treatment of 13 children with advanced, refractory or recurrent malignant tumors (42 procedures in total).


RESULTS
Our experiments showed 5-fold increase in rat survival during the first two days following application of extreme WBH due to the additional administration of urotropin. This regime demonstrated a significant inhibitory effect upon the growth of Sa 45. In children with progressive malignant tumors we achieved extreme WBH regimes (up to 43.2 degrees C) using urotropin without additional toxicity and with 69% overall response rate.


CONCLUSIONS
Extreme WBH (42.5-43.0 degrees C) could be used in the management of advanced and refractory cancer. Urotropin may play a favorable role during the procedures of extreme WBH, decreasing thermal damage to the body. Lymphocyte collection by lymphopheresis before WBH session and its reinfusion may be one of the progressive approaches for minimizing lymphocyte apoptosis.
Ismail-Zade
Reiman S
RS
Oncology Department, Belarusian Center for Pediatric Oncology and Hematology, P.O. Lesnoy, Minsk 223040, Belarus. reiman1955@mail.ru
D000293:Adolescent; D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects*; D017209:Apoptosis / Q000187:drug effects; D002648:Child; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects*; D008214:Lymphocytes / Q000187:drug effects / Q000473:pathology; D008297:Male; D008709:Methenamine / Q000009:adverse effects*; D009369:Neoplasms / Q000628:therapy*; D051381:Rats; D016879:Salvage Therapy
D000970:Antineoplastic Agents; D008709:Methenamine