Phase III study of interstitial thermoradiotherapy compared with interstitial radiotherapy alone in the treatment of recurrent or persistent human tumors: A prospectively controlled randomized study by the radiation therapy oncology group

Emami, B.; Scott, Charles; Perez, Cesar A.; Asbell, Sucha O.; Swift, Patrick S.; Grigsby, P.W.; Montesano, Angelica T.; Rubin, Philip; Curran, W.J.; DelRowe, John; Arastu, Hyder; Fu, Kai‐Yuan; Moros, Eduardo G.

doi:10.1016/0360-3016(93)90675-l

Cited by 18 publications

(22 citation statements)

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“…A numerical model was also created [52], showing good correlation of simulations to measured results. There were several other variations and hybrids including modified dipoles with a helical tip that successfully combined the phase relationship of a dipole and the tip-heating of a helical antenna [17]. These had improved performance in arrays when compared to a helical array.…”

Section: Mw Antenna Design Evolutionmentioning

confidence: 97%

“…Microwaves have been reported to have several advantages over other technologies: (1) deep penetration [53,77,79,84]; (2) no direct electrical contact required (thus all metallic surfaces may be coated with non-stick coatings) [54]; (3) rapid heating with shorter ablation times [77,84,97]; (4) no power delivery limitations due to tissue charring [54,75,98]; (5) allows for deeper penetration due to an increase in transparency to microwaves even with near field tissue desiccation [90]; (6) higher temperatures [54,97,99]; (7) coagulation of vessels [53,73,75,78,98] and an improved convection profile [78,84,99]; (8) heats large volumes [53,56,57,73,75,76,84,87,96,98,99], and (9) provides advantages due to the phase relationships between antennas (allowing constructive or destructive interference) [16][17][18][35][36][37][38]. MW ablation has clinical relevance in providing an alternative to surgical resection [8...…”

Section: Validation Of Mw Performancementioning

confidence: 99%

“…In ablation thermal therapy for cancer, MW antennas are usually inserted parallel to one another, with the tips in the same plane [37]. If one deviates from either of these conditions (parallel insertion and tip alignment), treatment planning is recommended to help predict the consequences (especially since the presence of cold spots could lead to recurrence) [17]. The more elliptical shape of some MW ablations may also be an advantage for larger tumours.…”

Section: Treatment Planningmentioning

confidence: 99%

“…Interstitial hyperthermia for localised cancer was found to effectively heat tumours and provide local control [7][8][9][10][11][12][13][14] and significantly boost the effectiveness of both radiation therapy and chemotherapy in randomised trials [7,15,16]. No difference was seen in radiation with or without heat for complete response if the hyperthermia treatment did not meet its temperature goals of 42.5 C for 45 to 60 min in the entire tumour [17].…”

Section: Introductionmentioning

confidence: 96%

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Interstitial microwave transition from hyperthermia to ablation: Historical perspectives and current trends in thermal therapy

Ryan¹,

Turner

Hamilton

2010

International Journal of Hyperthermia

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This work reviews the transition from hyperthermia to ablation for cancer treatment with interstitial microwave (MW) antennas. Early work utilising MW energy for thermal treatment of cancer tissue began in the late 1970s using single antennas applied interstitially or the use of multiple interstitial antennas driven with the same phase and equal power at 915 or 2450 MHz. The original antenna designs utilised monopole or dipole configurations. Early work in thermal therapy in the hyperthermia field eventually led to utilisation of these antennas and methods for MW ablation of tumours. Efforts to boost the radiated MW power levels while decreasing antenna shaft temperatures led to incorporation of internally cooled antennas for ablation. To address larger tumours, MW treatment utilised arrays that were simultaneously activated by either non-synchronous or synchronous phase operation, benefiting both hyperthermia and ablation strategies. Numerical modelling was used to provide treatment planning guidance for hyperthermia treatments and is expected to provide a similar benefit for ablation therapy. Although this is primarily a review paper, some new data are included. These new data show that three antennas with 2.5 cm spacing at 45 W/channel and 10 min resulted in a volume of 89.8 cm(3) when operated synchronously, but only 53.4 cm(3) non-synchronously. Efficiency was 1.1 (synchronous) versus 0.7 (non-synchronous). MW systems, treatment planning, and image guidance continue to evolve to provide better tools and options for clinicians and patients in order to provide better approach and targeting optimisation with the goal of improved treatment for the patient.

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Section: Mw Antenna Design Evolutionmentioning

confidence: 97%

Section: Validation Of Mw Performancementioning

confidence: 99%

Section: Treatment Planningmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

See 2 more Smart Citations

Interstitial microwave transition from hyperthermia to ablation: Historical perspectives and current trends in thermal therapy

Ryan¹,

Turner

Hamilton

2010

International Journal of Hyperthermia

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“…Patients with STS involving or extending to neurovascular structures may be sometimes advised to undergo an amputation. In an effort to preserve limbs, conservative surgery with various modalities such as nerve resection with or without nerve grafts, irradiation, and hyperthermia for preservation of peripheral nerves has been reported [1-4]. Brachytherapy, interstitial tumor bed irradiation, following conservative surgery has been shown to provide excellent local control and limb preservation in patients with STS, whereas little is known about the tolerance of peripheral nerves to brachytherapy.…”

Section: Introductionmentioning

confidence: 99%

Nerve tolerance to high-dose-rate brachytherapy in patients with soft tissue sarcoma: a retrospective study

et al. 2005

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Background: Brachytherapy, interstitial tumor bed irradiation, following conservative surgery has been shown to provide excellent local control and limb preservation in patients with soft tissue sarcomas (STS), whereas little is known about the tolerance of peripheral nerves to brachytherapy. In particular, nerve tolerance to high-dose-rate (HDR) brachytherapy has never been properly evaluated. In this study, we examined the efficacy and radiation neurotoxicity of HDR brachytherapy in patients with STS in contact with neurovascular structures.

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Fractionated brain stereotactic irradiation using a non‐invasive frame: Technique and preliminary results

Delannes

Daly-Schveitzer

Sabatier

et al. 1994

Radation Oncology Invest

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In this study we report on the use of two non‐invasive head frames in fractionated stereotactic irradiation for small benign or low grade brain tumors. Sixty‐one patients were treated from April 1988 to December 1992 with external stereotactic irradiation: 12 presented with arteriovenous malformations (AVMs), 32 with benign tumors, and 17 with malignant tumors. Sire of the lesions ranged from 15 to 45 mm in diameter. Two immobilization devices were used: the Laitinen stereoadapter, until December 1992, and then the Beverly frame, specifically designed for radiotherapy. Treatment was given daily, 5 days/week, using 1 or 2 non‐coplanar arcs, the dose per fraction ranging from 2 to 3 Gy. The study of the accuracy of the two frames showed an average discrepancy <1 mm for 25 setups, irrespective of the spatial plane. All the patients tolerated well the immobilization devices. Forty‐one of the 61 patients were followed at least 2 years after the treatment (7 with AVMs, 20 with benign tumors, 14 with malignant tumors). For AVMs, 1 regressed completely, 1 partially decreased in size, and the other 5 remained unchanged. For benign tumors, 14 patients are alive without disease progression, 5 showed a marked tumor decrease, and 1 died of intercurrent disease. For malignant tumors, 3 patients died of their disease, 2 are alive with disease progression, 8 are alive without disease progression, and 1 has a complete tumor regression. From these results we conclude that the Beverly frame is perfectly suited to fractionated stereotactic irradiation. For AVMs, the obliteration rate with fractionated irradiation at low dose is disappointing. These lesions probably require larger single dose treatments to induce vascular sclerosis. For other benign or low grade tumors, the observed results are satisfactory and the progression‐free rate may be as high as that obtained with single fractions with presumably less adverse effects. © Wiley‐Liss, Inc.

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Phase III study of interstitial thermoradiotherapy compared with interstitial radiotherapy alone in the treatment of recurrent or persistent human tumors: A prospectively controlled randomized study by the radiation therapy oncology group

Cited by 18 publications

References 0 publications

Interstitial microwave transition from hyperthermia to ablation: Historical perspectives and current trends in thermal therapy

Interstitial microwave transition from hyperthermia to ablation: Historical perspectives and current trends in thermal therapy

Nerve tolerance to high-dose-rate brachytherapy in patients with soft tissue sarcoma: a retrospective study

Fractionated brain stereotactic irradiation using a non‐invasive frame: Technique and preliminary results

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