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Seventy patients with far-advanced histologically proven malignancies were treated with a combination of microwave irradiation (433.92 MHz) and ionizing radiation. Of the twenty-one patients who completed the planned course of treatments and are eligible for a minimum of nine-month follow-up, 90% experienced complete relief of symptoms and 10% received partial relief of symptoms. Complete regression of all localized tumor occurred in sixteen of the twenty patients (80%), and nine of the complete responders remain free of disease from nine to fourteen months. It was the opinion of the clinicians involved in this study that the heat administered by the microwave unit potentiated the effects of ionizing radiation over those which would have been seen if radiation were used alone. In view of the fact that all patients in this study had cancers which were previously considered to be refractory to further medical treatment, the marked relief of symptoms and tumor response to combined therapy were encouraging. This preliminary study confirms the impression that the effects of radiation are enhanced by heat and forms the basis for a randomized series involving far-advanced but previously untreated head and neck and gynecological malignancies.

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Many healthcare systems are being redesigned to deliver local care with more services within the community. Relocation may enhance access but other aspects of healthcare quality should also be considered, notably waiting times and equity of care. This study examined a musculoskeletal physiotherapy service using a discrete event simulation with simple heuristics to model patient-behaviour. This combination provided an effective mechanism for incorporating the individuality of the patients in the flows along the patient-pathways, subject to the varying availabilities of key resources. In particular it captured the feedback that is critical in system performance, especially where waiting times are important. The model recognised the heterogeneity of patient attitudes and demonstrated how the behaviour of a relatively small proportion can affect the experience of all patients. The study suggested that, with careful operational management, more care could be delivered locally while exploiting many of the benefits of a centralised service.

Seventy-two patients with advanced cancer were treated with combinations of heat and radiation in two groups: (a) heat + radiation, and (b) radiation + heat. Of those treated with heat prior to radiation therapy, 32/60 (53%) experienced complete remission of symptoms. In the group exposed to heat after radiotherapy, 11/12 patients (92%) achieved complete remission. The authors present two cases and a review of the literature.