Interstitial thermoradiotherapy with ferromagnetic implants for locally advanced and recurrent neoplasms

Mack, C.; Stea, Baldassare; Kittelson, John M.; Shimm, David S.; Sneed, Penny K.; Phillips, Theodore L.; Swift, Patrick S.; Luk, Ken; Stauffer, Paul R.; Chan, Kwok Wah; Steeves, Richard A.; Cassady, J. Robert; Cetas, Thomas C.

doi:10.1016/0360-3016(93)90427-w

Cited by 27 publications

(15 citation statements)

References 22 publications

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“…In order to generate heat, we propose to distribute small 1 mm spherical ferromagnetic particles uniformly throughout the interior of a patient-customized silicone implant that fills the tumor resection cavity. This contrasts with the traditional use of ferromagnetic implant arrays which are highly invasive and require numerous closely spaced interstitial needles or catheters throughout an intact tumor volume (Chin and Stauffer, 1991, Stauffer et al, 1984b, Stauffer et al, 1984a, Mack et al, 1993, Tompkins et al, 1994. That multiple needle implant procedure is time intensive for the surgeon and painful for the patient, and if the spacing is increased from 1.0 towards 1.5 cm for clinical practicality, the ability to achieve homogenous heating within the target volume becomes compromised (Chin and Stauffer, 1991).…”

Section: Discussionmentioning

confidence: 76%

“…This ensures the treatment will be safe and well-tolerated clinically, even better than previously reported clinical trials of ferromagnetic implant hyperthermia (Stea et al, 1990, Stea et al, 1994, Tucker et al, 2000, Mack et al, 1993. Although practical tumor bed implants will have considerably more complex shape than the simple spherical implant studied in this work, the ability to heat up to 10 mm radially around a large implant and the low field required to heat the implant demonstrate the potential for this hyperthermia approach.…”

Section: Discussionmentioning

confidence: 80%

“…One of the advantages of this method stems from its potential to be readily combined with intraoperative contact hyperthermia for additional improvement in patient outcomes. This type of hyperthermia is akin to ferromagnetic thermoseed hyperthermia except its aim is not to heat a large tumor as in previous studies (Mack et al, 1993, Stauffer et al, 1984a, Tucker et al, 2000, but rather just a thin shell (~5 mm) of at-risk tissue surrounding a tumor resection cavity. Precise localization of treatment to just the tumor bed can be achieved using a custom fitting implant to deliver both brachytherapy and hyperthermia.…”

Section: Discussionmentioning

confidence: 99%

“…As has been reported previously, this field is well tolerated clinically even in large patients, effectively coupling energy into implanted ferromagnetic seeds while minimizing undesired heating of normal tissues (Mack et al, 1993, Stauffer et al, 1994. In practice, the field strength should be determined for the worst case high perfusion scenario while using ferroseed materials that undergo their Curie point transition from magnetic to non-magnetic at the desired treatment temperature , Cetas et al, 1998, Kobayashi et al, 1986.…”

Section: Discussionmentioning

confidence: 99%

“…One hot source technique that overcomes these issues is the use of external magnetic fields to couple energy non-invasively into implanted ferromagnetic needles or spheres (ferroseeds). This minimally invasive approach has been investigated by numerous groups beginning almost 45 years ago , Burton et al, 1971, Kobayashi et al, 1986, Stauffer et al, 1984a, Mack et al, 1993, Tucker et al, 2000, Stauffer et al, 1984b. When these 1-2 mm diameter ferromagnetic materials are immersed in a sub-megahertz radiofrequency magnetic field, eddy currents are induced on the metal surface.…”

Section: Introductionmentioning

confidence: 99%

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Tumor bed brachytherapy for locally advanced laryngeal cancer: a feasibility assessment of combination with ferromagnetic hyperthermia

Stauffer¹,

Vasilchenko²,

Osintsev³

et al. 2016

Biomed. Phys. Eng. Express

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Purpose. To assess the feasibility of adding hyperthermia to an original method of organ-preserving brachytherapy treatment for locally advanced head and neck tumors. Methods and materials. The method involves organ-preserving tumor resection and adjunctive high-dose-rate (HDR) brachytherapy delivered via afterloading catheters. These catheters are embedded in a polymeric implant prepared intraoperatively to fill the resection cavity, allowing precise computer planning of dose distribution in the surrounding at-risk tumor bed tissue. Theoretical and experimental analyzes address the feasibility of heating the tumor bed implant by coupling energy from a 100 kHz magnetic field applied externally into ferromagnetic particles, which are uniformly distributed within the implant. The goal is to combine adjuvant hyperthermia (40 °C-45 °C) to at-risk tissue within 5 mm of the resection cavity for thermal enhancement of radiation and chemotherapy response. Results. A fiveyear relapse free survival rate of 95.8% was obtained for a select group of 48 male patients with T3N0M0 larynx tumors, when combining organ-preserving surgery with HDR brachytherapy from a tumor bed implant. Anticipating the need for additional treatment in patients with more advanced disease, a theoretical analysis demonstrates the ability to heat at-risk tissue up to 10 mm from the surface of an implant filled with magnetically coupled ferromagnetic balls. Using a laboratory induction heating system, it takes just over 2 min to increase the target tissue temperature by 10 °C using a 19% volume fraction of ferromagnetic spheres in a 2 cm diameter silicone implant. Conclusion. The promising clinical results of a 48 patient pilot study demonstrate the feasibility of a new organ sparing treatment for laryngeal cancer. Anticipating the need for additional therapy, theoretical estimations of potential implant heating are confirmed with laboratory experiments, preparing the way for future implementation of a thermobrachytherapy implant approach for organ-sparing treatment of locally advanced laryngeal cancer.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Tumor bed brachytherapy for locally advanced laryngeal cancer: a feasibility assessment of combination with ferromagnetic hyperthermia

Stauffer¹,

Vasilchenko²,

Osintsev³

et al. 2016

Biomed. Phys. Eng. Express

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Clinical Practice of Interstitial Thermoradiotherapy

Seegenschmiedt

Klautke

Seidel

et al. 1996

Thermoradiotherapy and Thermochemotherapy

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Magnetic Hyperthermia as an adjuvant cancer therapy in combination with radiotherapy versus radiotherapy alone for recurrent/progressive glioblastoma: a systematic review

et al. 2021

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Introduction Hyperthermia therapy (HT) is a recognized treatment modality, that can sensitize tumors to the effects of radiotherapy (RT) and chemotherapy by heating up tumor cells to 40-45 °C. The advantages of noninvasive inductive magnetic hyperthermia (MH) over RT or chemotherapy in the treatment of recurrent/progressive glioma have been confirmed by several clinical trials. Thus, here we have conducted a systematic review to provide a concise, albeit brief, account of the currently available literature regarding this topic. Methods Five databases, PubMed/Medline, Embace, Ovid, WOS, and Scopus, were investigated to identify clinical studies comparing overall survival (OS) following RT/chemotherapy versus RT/chemotherapy + MH. Results Eleven articles were selected for this systematic review, including reports on 227 glioma patients who met the study inclusion criteria. The papers included in this review comprised nine pilot clinical trials, one non-randomized clinical trial, and one retrospective investigation. As the clinical trials suggested, MH improved OS in primary glioblastoma (GBM), however, in the case of recurrent glioblastoma, no significant change in OS was reported. All 11 studies ascertained that no major side effects were observed during MH therapy. Conclusion Our systematic review indicates that MH therapy as an adjuvant for RT could result in improved survival, compared to the therapeutic outcomes achieved with RT alone in GBM, especially by intratumoral injection of magnetic nanoparticles. However, heterogeneity in the methodology of the most well-known studies, and differences in the study design may significantly limit the extent to which conclusions can be drawn. Thus, further investigations are required to shed more light on the efficacy of MH therapy as an adjuvant treatment modality in GBM.

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Interstitial thermoradiotherapy with ferromagnetic implants for locally advanced and recurrent neoplasms

Cited by 27 publications

References 22 publications

Tumor bed brachytherapy for locally advanced laryngeal cancer: a feasibility assessment of combination with ferromagnetic hyperthermia

Tumor bed brachytherapy for locally advanced laryngeal cancer: a feasibility assessment of combination with ferromagnetic hyperthermia

Clinical Practice of Interstitial Thermoradiotherapy

Magnetic Hyperthermia as an adjuvant cancer therapy in combination with radiotherapy versus radiotherapy alone for recurrent/progressive glioblastoma: a systematic review

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