title: Association of acute adverse effects with high local SAR induced in the brain from prolonged RF head and neck hyperthermia.
abstract: To provide an adequate level of protection for humans from exposure to radio-frequency (RF) electromagnetic fields (EMF) and to assure that any adverse health effects are avoided. The basic restrictions in terms of the specific energy absorption rate (SAR) were prescribed by IEEE and ICNIRP. An example of a therapeutic application of non-ionizing EMF is hyperthermia (HT), in which intense RF energy is focused at a target region. Deep HT in the head and neck (H&N) region involves inducing energy at 434 MHz for 60 min on target. Still, stray exposure of the brain is considerable, but to date only very limited side-effects were observed. The objective of this study is to investigate the stringency of the current basic restrictions by relating the induced EM dose in the brain of patients treated with deep head and neck (H&N) HT to the scored acute health effects. We performed a simulation study to calculate the induced peak 10 g spatial-averaged SAR (psSAR₁₀g) in the brains of 16 selected H&N patients who received the highest SAR exposure in the brain, i.e. who had the minimum brain-target distance and received high forwarded power during treatment. The results show that the maximum induced SAR in the brain of the patients can exceed the current basic restrictions (IEEE and ICNIRP) on psSAR₁₀g for occupational environments by 14 times. Even considering the high local SAR in the brain, evaluation of acute effects by the common toxicity criteria (CTC) scores revealed no indication of a serious acute neurological effect. In addition, this study provides pioneering quantitative human data on the association between maximum brain SAR level and acute adverse effects when brains are exposed to prolonged RF EMF.
authors.affiliation: Department of Radiation Oncology, Erasmus MC, Daniel den Hoed Cancer Center, Hyperthermia Unit, Rotterdam, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Adibzadeh
authors.forename: R F
authors.initials: RF
authors.lastname: Verhaart
authors.forename: G M
authors.initials: GM
authors.lastname: Verduijn
authors.forename: V
authors.initials: V
authors.lastname: Fortunati
authors.forename: Z
authors.initials: Z
authors.lastname: Rijnen
authors.forename: M
authors.initials: M
authors.lastname: Franckena
authors.forename: G C
authors.initials: GC
authors.lastname: van Rhoon
authors.forename: M M
authors.initials: MM
authors.lastname: Paulides
mesh_terms: D001921:Brain / Q000528:radiation effects*; D004574:Electromagnetic Fields / Q000009:adverse effects*; D005334:Fever / Q000209:etiology*; D006257:Head / Q000528:radiation effects*; D006801:Humans; D009333:Neck / Q000528:radiation effects*; D011846:Radio Waves / Q000009:adverse effects*