Reirradiation combined with hyperthermia in breast cancer recurrences: Overview of experience in Erasmus MC

Abstract

For superficial hyperthermia a custom-built multi-applicator multi-amplifier superficial hyperthermia system operating at 433 MHz is utilised. Up to 6 Lucite Cone applicators can be used simultaneously to treat an area of 600 cm2. Temperatures are measured continuously with fibre optic multi-sensor probes. For patients with non-standard clinical problems, hyperthermia treatment planning is used to support decision making with regard to treatment strategy. In 74% of our patients with recurrent breast cancer treated with a reirradiation scheme of 8 fractions of 4 Gy in 4 weeks, combined with 4 or 8 hyperthermia treatments, a complete response is achieved, approximately twice as high as the CR rate following the same reirradation alone. The CR rate in tumours smaller than 30 mm is 80-90%, for larger tumours it is 65%. Hyperthermia appears beneficial for patients with microscopic residual tumour as well. To achieve high CR rates it is important to heat the whole radiotherapy field, and to use an adequate heating technique.

Gene networks related to the cell death elicited by hyperthermia in human oral squamous cell carcinoma HSC-3 cells

“…HT in combination with other treatments has been considered a promising approach in cancer therapy (3)(4)(5)(6)(7). Thus, the current data will help enable the rational design of more effective strategies for future HT therapy in OSCC cells.…”

“…Local hyperthermia (HT) for various malignant tumors including OSCC has been recognized as an effective and attractive tool with the advantages of relatively few side effects and slight damage to normal tissue. Combinations of HT with chemotherapy, radiotherapy or both have been clinically used for patients with cancer in various organs, and their antitumor effects have been verified by many clinical trials (3)(4)(5)(6)(7).…”

Impact of silicone and metal port-a-cath implants on superficial hyperthermia treatment quality

“…Dielectric and thermal tissues properties used for the models at 433 MHz [11,12]. direction of every LCA is rotated 90 degrees for each consequent treatment [1,13]. In this study two different E-field directions of the LCA were analysed: (1) E-field direction parallel to the body axis, and (2) E-field direction perpendicular to the body axis.…”

“…Usually at the Erasmus MC Cancer Institute a hyperthermia treatment is applied four times; each treatment lasts 1 h [1]. For a more uniform overall SAR coverage, the E-field Examples of a metallic and silicone port-a-cath which can be implanted in patients treated with hyperthermia [6].…”

“…a pacemaker, metallic implants larger than surgical clips are considered as contraindications for treatment due to the risk of high and very localized hot spots [1]. In general, three types of implants can be differentiated: (1) metallic implants, (2) active medical devices and (3) passive non-metallic implants.…”