Hyperthermia classic commentary: ‘A randomized clinical trial of radiation therapy versus thermoradiotherapy in stage IIIB cervical carcinoma’ by Yoko Harima,International Journal of Hyperthermia2001;17:97–105

Abstract

In our classic paper, we investigated both the clinical response and survival of patients treated with radiotherapy (RT) or thermoradiotherapy (TRT; RT plus hyperthermia [HT]) for Stage IIIB cervical carcinomas. Our study clearly demonstrated that TRT can result in beneficial effects for complete response and/or local relapse-free survival. To date, six randomized trials including our study have been published on the additive effect of HT in patients with locally advanced cervical cancer. In contrast, the combination of RT and platinum-based chemotherapy (CT) has gained wide acceptance. However, two recent meta-analyses suggested that the impact of adding CT to RT is less obvious in patients with advanced-stage tumors. Conversely, four of six randomized trials comparing the results of RT alone with TRT showed a beneficial effect for the patients with Stage IIIB tumors. From this, the patients with higher stage or bulkier tumors may benefit more from the addition of HT to RT than the addition of CT. To demonstrate the effectiveness of TRT for some cancers, including locally advanced cervical cancer, well designed randomized clinical trials are necessary.

“A randomized clinical trial of radiation therapy versus thermoradiotherapy in stage IIIB cervical carcinoma” of Yoko Harima et al. (2001): multiple biases and no advantage of hyperthermia

“…As such, it was reprinted in the IJH in 2009 [2] accompanied with a "hyperthermia classic commentary" of the key researchers Y. Harima and S. Sawada. They concluded that "our study clearly demonstrated that TRT can result in beneficial effects for complete response and/or local relapse-free survival" [3]. Preparing a systematic review of hyperthermia in the treatment of LACC, [4] we performed a thorough data appraisal, including a comprehensive bias analysis and recalculation of each parameter reported in the original trials (if possible).…”