Microwave hyperthermia as an adjunct to radiation therapy: Summary experience of 256 multifraction treatment cases

Bicher, Haim I.; Wolfstein, Ralph S.; Lewinsky, Bernard S.; Frey, Harvey S.; Fingerhut, Aaron G.

doi:10.1016/0360-3016(86)90294-4

Cited by 22 publications

(6 citation statements)

References 17 publications

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“…Clinical trials have shown therapeutic MW use with hyperthermia over a range of anatomical sites: bone [53], pancreas [54], biliary tree [28], rectum [55], chest wall [56], brain [57,58], bladder [59] and prostate [49]. Hyperthermia showed very good clinical promise when an adequate heat dose could be delivered.…”

Section: Clinical Significancementioning

confidence: 99%

Interstitial microwave treatment for cancer: historical basis and current techniques in antenna design and performance

Ryan¹,

Brace

2016

International Journal of Hyperthermia

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The use of microwaves (MW) for thermal cancer treatment began in the late 1970s. At first, hyperthermia was induced by using single antennas applied interstitially. This was followed by arrays of multiple interstitial antennas driven synchronously at 915 or 2450 MHz. This early work focused on hyperthermia as an adjuvant therapy, but more recently has evolved into a thermally ablative monotherapy. Increased power required to thermally ablate tissues required additional developments such as internally cooled antennas. Larger tumours have also been ablated with MW antenna arrays activated synchronously or non-synchronously. Numerical modelling has provided clinical treatment planning guidance and device design insight throughout this history. MW thermal therapy systems, treatment planning, navigation and image guidance continue to evolve to provide better tools and options for clinicians and patients in order to provide targeting optimisation with the goal of improved treatment for the patient and durable cancer eradication. This paper reviews the history and related technological developments, including antenna design, of MW heating for both hyperthermia and ablation.

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Section: Clinical Significancementioning

confidence: 99%

Interstitial microwave treatment for cancer: historical basis and current techniques in antenna design and performance

Ryan¹,

Brace

2016

International Journal of Hyperthermia

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“…Based on these early results and our own experience [11][12][13][14][15]21] as well as several prospective randomized trials proving the safety and efficacy of thermoradiotherapy [40,47,52] we undertook to treat "de novo" a subpopulation of patients that refused conventional treatment. The safety and efficacy of thermoradiotherapy has been often proved, but a reluctance still exists to make the modal- …”

Section: Discussionmentioning

confidence: 99%

“…It has been proven in malignant cancers, metastatic nodes in the head and neck region [3-5, 38, 39, 45] and several other locations [11,15,36] that hyperthermia potentiates radiation therapy. Due to these early findings, clinical applications were limited to recurrent advanced or metastatic cancers [25,27,46].…”

Section: * Introductionmentioning

confidence: 99%

Thermoradiotherapy with curative intent - Breast, head, neck and prostate tumors

Bicher¹,

Al‐Bussam²

2006

DZO

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“…To decide what is the most appropriate thermal dose parameter is less obvious. Whenever there is a dispute on the outcome of a clinical trial [8][9][10], the recognition of uncommon hyperthermia schedules or mechanisms (once per week or daily hyperthermia fractions [11]), the (im)possibility of the requirement to measure the tumour temperature or indicative tumour temperature [12,13], biological mechanisms [4,5] or publication of studies demonstrating the existence of indisputable thermal dose-effect relationships [14][15][16][17][18][19][20][21] or demonstrating the lack of a thermal dose-effect relationship [22], discussion flares up. A single widely accepted thermal dose parameter has not been defined yet and the discussion of what is the most appropriate thermal dose parameter is still ongoing.…”

Section: Introductionmentioning

confidence: 99%

Is CEM43 still a relevant thermal dose parameter for hyperthermia treatment monitoring?

Rhoon

2016

International Journal of Hyperthermia

147

135

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CEM43 has its roots in the direct cytotoxic effect of heat, whereby the amount of cell death depends on the temperature and exposure time. CEM43 is a normalising method to convert the various time-temperature exposures applied into an equivalent exposure time expressed as minutes at the reference temperature of 43 °C. The CEM43 concept also holds a number of weaknesses, however. When used to predict treatment efficacy of combined radiotherapy plus hyperthermia, CEM43 does not include the effect of sensitisation by enhanced oxygenation, variation in interval time and the effect of multiple fractions. Further, it does not include the effect of increased perfusion at the lower thermal dose - and the occurrence of stasis at the higher thermal dose. Overall, studies towards a thermal dose-effect relationship in radiotherapy plus hyperthermia present a diffuse message without a definitive conclusion. However, prospective studies and studies with large patient numbers did report significant thermal dose-effect relationships and provide a good reason to continue research in the CEM43 model. Such research would be best performed in homogeneous patient groups with a single pathology and a low variation in tumour size and heterogeneity. Further, high quality thermometry, strict treatment schedules with fixed intervals and preferably homogenous heating are important requirements to enhance the probability of detecting a thermal dose-effect relationship. The slowly growing availability of hybrid MR hyperthermia systems should be a strong stimulus to expand these studies with the inclusion of measuring thermal dose-dependent blood flow and oxygen changes in the tumour and normal tissues.

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Microwave hyperthermia as an adjunct to radiation therapy: Summary experience of 256 multifraction treatment cases

Cited by 22 publications

References 17 publications

Interstitial microwave treatment for cancer: historical basis and current techniques in antenna design and performance

Interstitial microwave treatment for cancer: historical basis and current techniques in antenna design and performance

Thermoradiotherapy with curative intent - Breast, head, neck and prostate tumors

Is CEM43 still a relevant thermal dose parameter for hyperthermia treatment monitoring?

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