Doxorubicin, cyclophosphamide, and whole body hyperthermia for treatment of advanced soft tissue sarcoma

Gerad, Henry; Echo, David A. Van; Whitacre, Margaret; Ashman, Michael; Helrich, Martin; Foy, J. M.; Ostrow, S.; Wiernik, Peter H.; Aisner, Joseph

doi:10.1002/1097-0142(19840615)53:12<2585::aid-cncr2820531203>3.0.co;2-2

Cited by 41 publications

(27 citation statements)

References 24 publications

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“…All these may cause cell death, either directly or by triggering the apoptotic pathways. [3] Interestingly, hyperthermia could hinder DNA repair, and can sensitize the cancer cells to DNA damaging agents, such as gemcitabine, [17,18] pyrimidine analogs, [19] cisplatin, [20–22] cyclophosphamide, [23,24] melphalan, [25,26] camptothecin, [27] PARP inhibitors-olaparib, PJ-34 [28,29] and so on. Additional studies suggested that hyperthermia could elevate the activity of quinoneoxido reductase (NQO1) in tumors to improve the cytotoxicity of β-lapachone against cancer cells both in vitro and in vivo .…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency deep hyperthermia combined with chemotherapy in the treatment of advanced non-small cell lung cancer

Yang

Xie

Lai

et al. 2019

Chinese Medical Journal

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Background In the era of precision medicine, chemotherapy is still considered the cornerstone of treatment for lung cancer patients without gene mutations. How to reduce the toxicity and increase the efficiency of chemotherapy is worth exploring. This study aimed to investigate the curative effects and safety of hyperthermia combined with chemotherapy (HCT) for advanced patients with non-small cell lung cancer (NSCLC), especially those with malignant pleural effusion. Methods We retrospectively evaluated medical records of 93 patients with advanced NSCLC (stage IIIB-IV) from March 2011 to January 2014. The patients were divided into HCT and chemotherapy (CT) groups. The HCT group was treated with gemcitabine and cisplatin (GP) regimen combined with regional radiofrequency deep hyperthermia, while the CT group was treated with GP regimen only. Those with malignant pleural effusion extra underwent thoracentesis and intrapleural injection chemotherapy combined with hyperthermic or not. Clinical treatment results and adverse reactions were compared and analyzed after treatment. SPSS 19.0 software (SPSS Inc., USA) was used for statistical data processing. P values less than 0.05 were accepted to be statistically significant. Results Among the 93 patients, HCT group included 48 patients (16 patients with malignant pleural effusion), CT group included 45 patients (10 patients with malignant pleural effusion). There was no significant difference between the two groups in patient characteristics. The overall response rate (ORR) of pleural effusions was much better in HCT group than that in CT group (81.2% vs . 40.0%, P = 0.046). The patients in HCT group had lower incidence rate of weakness (12.5% vs . 46.7%, χ 2 = 13.16, P < 0.001) and gastrointestinal (25.0% vs . 77.8%, χ 2 = 25.88, P < 0.001) adverse reactions than that in CT group. The objective tumor response and survival showed no significant differences. Conclusions Hyperthermia combined with chemotherapy might lead to the development of better therapeutic strategy for advanced NSCLC with malignant pleural effusion patients. Also, it could greatly reduce the chemotherapy toxic effects in the incidence of weakness and gastrointestinal adverse reactions in advanced NSCLC patients.

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Section: Discussionmentioning

confidence: 99%

Radiofrequency deep hyperthermia combined with chemotherapy in the treatment of advanced non-small cell lung cancer

Yang

Xie

Lai

et al. 2019

Chinese Medical Journal

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“…Within a pilot study, 11 patients with advanced STS were treated with doxorubicin combined with whole body hyperthermia (WBH) followed by cyclophosphamide [19]. A large phase II trial using WBH in combination with ifosfamide, carboplatin, and etoposide (ICE chemotherapy) in patients with metastatic STS was published in 2003 with 108 patients enrolled.…”

Section: Thermochemotherapy In Sts Whole Body Hyperthermiamentioning

confidence: 99%

Hyperthermia in soft tissue sarcoma

Lindner

Issels

2011

Curr. Treat. Options in Oncol.

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Patients with high-risk soft tissue sarcomas (STS)-FNCLCC grade 2-3, size >5 cm, deep to the fascia-are at risk for developing local recurrence and distant metastasis despite surgical tumor resection. Therefore, the management of high-risk STS requires a multidisciplinary approach. Besides surgery, radiotherapy, and chemotherapy, regional hyperthermia (RHT) has the potential to become the fourth standard treatment modality for the treatment of these patients. RHT means non-invasive selective heating of the tumor area to temperatures within the range of 40-43°C for 60 min by the use of an electromagnetic heating device. Thereby RHT is always applied in addition to radiotherapy or chemotherapy or both but is not effective as a single treatment. Beside direct cytotoxicity, RHT in combination with chemotherapy enhances the drug cytotoxicity mainly by increased chemical reaction and intratumoral drug accumulation. For the neoadjuvant setting, RHT in combination with a doxorubicin- and ifosfamide-based chemotherapy has been shown to dramatically improve the tumor response rate but also prevents from early disease progression as compared to chemotherapy alone. The addition of RHT to a multimodal treatment of high-risk STS consisting of surgery, radiotherapy, and chemotherapy either in the neoadjuvant setting but also after incomplete or marginal tumor resection has been shown to significantly improve local recurrence- and disease-free survival. Based on these results and in conjunction with the low RHT-related toxicity, RHT combined with preoperative or postoperative chemotherapy should be considered as an additional standard treatment option for the multidisciplinary treatment of locally advanced high-grade STS.

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“…Die Probleme bei der Ganzkörperhyperthermie ergeben sich aus der Begrenzung der Temperaturhöhe, die im allgemeinen zur vollständigen Tumorvernichtung nicht ausreicht, und der Beherrschung der Temperaturauswirkungen auf Kreislauf, Zentralnervensystem, Atmung und metabolische Prozesse. Viele Untersuchungen sind deshalb diesbezüglich im Gange, die letztlich über die Anwendbarkeit der Ganzkörperhyperthermie als standardisiertes Behandlungsverfahren mit spezifischen Indikationen entscheiden(ll, 12,14,17,23,25).…”

Section: Treatment Of Otherwise Incurable Malignant Tumours In Children By Hyperthermia and Chemotherapyunclassified

Behandlung konventionell inkurabler Tumorerkrankungen im Kindesalter mit Ganzkörperhyperthermie und Chemotherapie

Willnow¹,

Lindner²,

Brock³

et al. 2008

Dtsch med Wochenschr

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Conventional methods of treatment having failed in 17 children (aged 9/12 to 16 5/12 years) with incurable solid malignant tumours underwent whole-body hyperthermia (41.8-42.0 degrees C, for 2-3 h), hyperglycaemia (20-25 mmol/l) and polychemotherapy. Five children had neuroblastoma (stage 4), three Wilm's tumour (stage 4 or 5, unfavourable histology), five skeletal sarcoma with metastases, three inoperable malignant liver tumour, and one brainstem tumour of unknown histology. Whole-body hyperthermia was induced by extracorporeal blood warming in an haemodialysis apparatus under neuroleptic analgesia, thermistors measuring the temperature in the oesophagus, rectum, trachea and skin. There were on average four treatment sessions (between one and ten, total 58), a week apart. The result could be assessed in 12 children: one persisting complete remission (19 months-metastasising renal rhabdoid tumour), eight partial or incomplete remissions, and three nonresponders (osteogenic sarcoma; Ewing sarcoma; brainstem tumour). If the risk can be satisfactorily judged the method is useful and of bearable toxicity. The results point to a high antitumour effectiveness of combined hyperthermia and chemotherapy.

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Doxorubicin, cyclophosphamide, and whole body hyperthermia for treatment of advanced soft tissue sarcoma

Cited by 41 publications

References 24 publications

Radiofrequency deep hyperthermia combined with chemotherapy in the treatment of advanced non-small cell lung cancer

Radiofrequency deep hyperthermia combined with chemotherapy in the treatment of advanced non-small cell lung cancer

Hyperthermia in soft tissue sarcoma

Behandlung konventionell inkurabler Tumorerkrankungen im Kindesalter mit Ganzkörperhyperthermie und Chemotherapie

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