Use of combined radiation and hyperthermia for gynecological cancer.
OBJECTIVE
We reviewed all literature on the clinical use of combined radiation and hyperthermia for gynecologic malignancies.


RESULTS
Combined radiation and hyperthermia should be considered an alternative to chemoradiation for patients with locally advanced cervix cancer and be the first treatment of choice for these patients when radiation cannot be combined with chemotherapy. Several randomized trials have shown an improvement by adding hyperthermia to radiation that is comparable to the improvement found with the addition of chemotherapy to radiation. Hyperthermia does not seem to add to treatment-induced toxicity and the results of hyperthermia are consistent even at 12 years follow-up and could be reproduced in a large, unselected group of cervix cancer patients. A novel indication for combined radiotherapy and hyperthermia is vaginal cancer. Recently, a cohort study showed that the addition of hyperthermia to radiation seems to improve overall survival for patients with vaginal cancer International Federation of Gynecology and Obstetrics stage III.


CONCLUSIONS
Combined radiation and hyperthermia should be considered for patients with locally advanced cervix cancer (International Federation of Gynecology and Obstetrics stage IIb and upwards) as an alternative to chemoradiation for patients with a contraindication for chemotherapy. For other patients, the optimal treatment combination is the subject of randomized trials. For vaginal cancer, a prospective registration study is currently ongoing.
Franckena
Martine
M
Erasmus Medical Center, Daniel den Hoed Cancer Center, Department of Radiation Oncology, Rotterdam, The Netherlands. m.franckena@erasmusmc.nl
van der Zee
Jacoba
J
D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy* / Q000601:surgery / Q000628:therapy*; D014625:Vaginal Neoplasms / Q000628:therapy*