Combination hyperthermia and radiation therapy for malignant melanoma

Abstract

Since 1975, clinical studies have been carried out to determine whether radiation when combined with localized hyperthermia evokes improved tumor control compared to that achieved with radiation alone. Local tumor hyperthermia was achieved using radiofrequency inductive heating at 27.12 MHz. In bulky lesions (<100 cm3), radiofrequency conductive heating at 13.56 MHz was also used. More than 100 lesions in 38 patients were treated with radiation alone and hyperthermia in combination with radiation. Most lesions were treated either twice a week or once a week, depending on radiation dose fractionation scheme used. The overall result of tumor control rate of the combined therapy is superior to radiation therapy alone (75% versus 46%; P < 0.01). No enhanced normal tissue morbidity was seen following the combined therapy. The detailed analysis of the treatment results shows that the tumor control rate is dependent on dose per fraction, the total dose, and the initial tumor volume. The radiation alone, at high doses per fraction, was effective in controlling 80% of the lesions, if the tumor volume was less than 10 cm3, compared to 30% when the tumor volumes were larger. The combination therapy, on the other hand, effected 80% local tumor control regardless of the tumor volume. The importance of good thermal distribution within the tumor volume, selective heating of the tumor tissues and the sequence and time interval between the combined therapy is discussed.

Changes in muscle blood flow distribution during hyperthermia

“…Clinical investigations during the last decade have suggested that hyperthermia in combination with radiation therapy may be a promising modality for the treatment of cancer (Kim et al 1982, Perez er al. 1983, Luk et al 1984, Oleson er al.…”

Thermo-chemo-radiotherapy for advanced bile duct carcinoma

“…Hyperthermia involves two biological interactions with radiation, a radiosensitizing effect [9,10] and a direct cytotoxic effect on tumor cells [11] . When the target lesion is heated up to around 42 , the cancer-killing effect of radiation or anticancer drug is enhanced [12] .…”

The conservative management of choroidal melanoma

“…It has also been noted that hyperthermia and radiation are synergistic. 21 Transcleral diathermy for small melanomas is effective22 but causes extensive damage to overlying sclera, with the risk of extrascleral spread. More recently, Finger et aP3 showed good tumour response histologically without significant damage to the sclera using a 5 to 8 GHz ophthalmic microwave applicator.…”