Combining Mitomycin C and Regional 70 MHz Hyperthermia in Patients with Nonmuscle Invasive Bladder Cancer: A Pilot Study

Geijsen, Elisabeth D.; Reijke, Theo M. de; Koning, Caro C.E.; Vörding, Paul J. Zum Vörde Sive; Rosette, Jean J. de la; Rasch, Coen R. N.; Os, Rob M. van; Crezee, J.

doi:10.1016/j.juro.2015.05.102

Cited by 37 publications

(53 citation statements)

References 29 publications

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“…Moreover, hyperthermia is now readily available to treat a broad range of tumours, similar to radiotherapy and broad-spectrum chemotherapy, but unlike the latter two, hyperthermia has no severe side effects [10,111]. These beneficial features of hyperthermia together with the physiological and molecular effects that we have summarised in this review (Figure 1), illustrate the potential of hyperthermia treatment in oncology.…”

Section: The Future Of Hyperthermiamentioning

confidence: 76%

Improving efficacy of hyperthermia in oncology by exploiting biological mechanisms

Tempel¹,

Horsman

Kanaar³

2016

International Journal of Hyperthermia

102

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It has long been established that hyperthermia increases the therapeutic benefit of radiation and chemotherapy in cancer treatment. During the last few years there have been substantial technical improvements in the sources used to apply and measure heat, which greatly increases enthusiasm for the clinical use of hyperthermia. These advances are converging with a better understanding of the physiological and molecular effects of hyperthermia. Therefore, we are now at a juncture where the parameters that will influence the efficacy of hyperthermia in cancer treatment can be optimised in a more systematic and rational manner. In addition, the novel insights in hyperthermia's many biological effects on tumour cells will ultimately result in new treatment regimes. For example, the molecular effects of hyperthermia on the essential cellular process of DNA repair suggest novel combination therapies, with DNA damage response targeting drugs that should now be clinically explored. Here, we provide an overview of recent studies on the various macroscopic and microscopic biological effects of hyperthermia. We indicate the significance of these effects on current treatments and suggest how they will help design novel future treatments. ARTICLE HISTORY

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Section: The Future Of Hyperthermiamentioning

confidence: 76%

Improving efficacy of hyperthermia in oncology by exploiting biological mechanisms

Tempel¹,

Horsman

Kanaar³

2016

International Journal of Hyperthermia

102

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“…When the bladder temperature has reached 41 C, treatment is continued for 60 minutes, with a maximum total time of 90 minutes. Temperature measurements in the rectum and vagina are used to optimise phase settings for optimal bladder temperatures [18].…”

Section: Amc 70 Mhz Systemmentioning

confidence: 99%

“…Geijsen et al reported on 18 patients with intermediate-or high-risk NMIBC who were treated with MMC and regional hyperthermia after complete TURB [18]. Treatment consisted of an induction period of six once-weekly courses of MMC and regional hyperthermia.…”

Section: Amc 70 Mhz Systemmentioning

confidence: 99%

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Chemohyperthermia in non-muscle-invasive bladder cancer: An overview of the literature and recommendations

Liem

Crezee

Rosette

et al. 2016

International Journal of Hyperthermia

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Non-muscle-invasive bladder cancer (NMIBC) is characterised by a high risk of recurrence for the present standard treatment of transurethral resection of the bladder (TURB) followed by intravesical instillation of Mitomycin-C (MMC) or bacillus Calmette-Gu erin (BCG). To decrease this high recurrence rate, alternative treatments are studied. Intravesical MMC combined with hyperthermia could be an interesting alternative active treatment for intermediate-and high-risk NMIBC, and has been investigated in the past years. Hyperthermia, raising tumour temperatures to 40-44 C, can be achieved with several hyperthermia systems, based on three different techniques: 1) intravesical microwave induced heating, 2) conductive heating, and 3) loco-regional, using external radiofrequency antennas. In this review an overview is given of the available hyperthermia systems and the reported outcomes. Future directions are discussed. Optimal implementation of a combined regimen of MMC and hyperthermia requires further clinical trials to identify patients who will benefit most from this treatment, to optimise treatment schedules and to compare the efficacy of different hyperthermia devices. ARTICLE HISTORY

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“…Although, the recurrence rate of NMIBC is significantly decreased by TUR in combination with intravesical chemotherapy, the rate of cancer progression is not diminished (7)(8)(9)(10)(11)(12). Preventing recurrence of NMIBC after TUR remains challenging (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Bladder intracavitary hyperthermic perfusion chemotherapy for the prevention of recurrence of non-muscle invasive bladder cancer after transurethral resection

Cui

Wang

et al. 2017

Oncology Reports

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Abstract. Preventing the recurrence of non-muscle invasive bladder cancer (NMIBC) post-transurethral resection (TUR) remains challenging. The aim of the present study was to investigate the effectiveness and safety of bladder intracavitary hyperthermic perfusion chemotherapy (BHPC) for prevention of NMIBC recurrence post-TUR. Between December 2006 and December 2014, 53 patients with NMIBC who underwent TUR were randomly assigned to receive BHPC (BHPC group, 28 patients) or intravesical chemotherapy alone (chemotherapy group, 25 patients) at the Intracelom Hyperthermic Perfusion Therapy Center of Guangzhou Medical University Cancer Hospital (Guangzhou, China). BHPC was performed by combining perfusion-based hyperthermia with chemotherapeutic agent mitomycin C (MMC) in the bladder, and the chemotherapy group of patients received bladder MMC perfusion. The concentration of MMC in the perfusion fluid and serum were assessed at different time-points. Tumor recurrence, disease-free survival (DFS), and side-effects were recorded and compared between the 2 groups. Results revealed that BHPC was performed smoothly, at ~44̊C in the bladder cavity. Patients tolerated BHPC, and no side-effects were observed. Both BHPC and intravesical chemotherapy achieved a high MMC concentration in the bladder perfusion liquid, but low MMC concentration in the serum, although serum MMC concentrations in the BHPC group were significantly higher (P<0.05). The tumor recurrence rate was significantly lower (10.7 vs. 28.0%; P=0.02) and the DFS period was significantly longer (37±1.2 vs. 19±0.9 months; P=0.001) in the BHPC group than in the chemotherapy group. Our results demonstrated that BHPC is safe and effective for preventing NMIBC recurrence post-TUR and prolongs DFS.

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Combining Mitomycin C and Regional 70 MHz Hyperthermia in Patients with Nonmuscle Invasive Bladder Cancer: A Pilot Study

Abstract: Treatment with regional hyperthermia combined with mitomycin C in patients with intermediate and high risk nonmuscle invasive bladder cancer is feasible with low toxicity and excellent bladder temperatures.

Cited by 37 publications

References 29 publications

Improving efficacy of hyperthermia in oncology by exploiting biological mechanisms

Improving efficacy of hyperthermia in oncology by exploiting biological mechanisms

Chemohyperthermia in non-muscle-invasive bladder cancer: An overview of the literature and recommendations

Bladder intracavitary hyperthermic perfusion chemotherapy for the prevention of recurrence of non-muscle invasive bladder cancer after transurethral resection

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