Background: Concepts of integrative oncology (IO), as have been offered by anthroposophic medicine (AM) for decades, are gaining increasing interest and acceptance. Central aspects are multimodal therapeutic interventions, health-related quality of live, and patients' preference as well as therapeutic relationship and clinical outcome. Despite its broad application, IO lacks evaluation in clinical practice and complementary therapies are not monitored by any cancer registries. Methods: To close this gap we established ‘Network Oncology' (NO), a conjoint registry of German outpatient AM practitioners and AM hospitals. In this paper we present the project and a first data overview and compare it to epidemiological registers and current literature. Results: NO has collected 10,405 cancer patients' records in 6 years. Compared to epidemiological registers our data show minor differences in disease entity distribution, age, and gender. There is an overproportional amount of young breast cancer patients in NO institutions indicating a demand for integrative therapies in this group. There is no difference between the UICC (Union for International Cancer Control) stages at first diagnosis and at admission to a NO facility. According to our data conventional therapies were less frequently administered after admission to a NO facility. Nevertheless, one third of the patients received their first conventional therapy in a NO facility. 80% of the patients received mistletoe preparations and 63% had nonpharmacotherapeutic, complementary interventions. Conclusion: Integrative oncological approaches attract a great number of patients visiting AM institutions. The NO provides an infrastructure to evaluate integrative interventions in AM, allows comparison to other clinical registers, and thus can contribute to health service research in this field.
Hyperthermia can play a role in curative multimodal therapies of locally advanced malignancies. Firstly, the downstaging rate can be increased in pre-operative therapies (resectability, organ preservation), and secondly the local control can be improved. The synergistic effect of hyperthermia at 42-43 °C when combined with radiotherapy has been demonstrated in pre-clinical studies and in phase III studies as well. Furthermore, there are interactions with numerous cytotoxic drugs and un-specific as well as specific immunological processes, the value of which for clinical application has not yet been determined. The future of the clinical use of hyperthermia will be determined to a large extent by developments and improvements in the technology used, and the greatest potential lies in advancing radiofrequency equipment. Infrared whole-body hyperthermia also made progress in the past few years. We outline oncological concepts to apply hyperthermia for advanced rectal carcinomas, carcinomas of the bladder, oesophageal carcinomas and soft-tissue sarcomas. In this work we summarise results relating to hyperthermia performed on these tumour entities and details of possible therapeutic strategies. We also look at technical approaches to improved quality control of the heat delivery device, as well as planning, monitoring and verification of power application and temperature distribution.
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