Results of surgery and radio-hyperthermo-chemotherapy for patients with soft-tissue sarcoma

Otsuka, Takanobu; Yonezawa, Masato; Kamiyama, Fumiaki; Matsushita, Yasuyuki; Matsui, Nobuo

doi:10.1007/pl00012114

Cited by 26 publications

(14 citation statements)

References 30 publications

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“…Hyperthermia is already applied for the treatment of soft tissue sarcoma. The combination therapy using both cytotoxic drugs and regional hyperthermia in the treatment of soft tissue sarcoma is based upon experimental and clinical evidence showing that heat induces tumor cell death by direct thermal toxicity and enhances the efficacy of some drugs, such as alkylating agents and platinum analogs [36,37]. Recently micro-or nano-particles have attracted attention as a new heat source.…”

Section: Perspectivesmentioning

confidence: 99%

A novel hyperthermia treatment for bone metastases using magnetic materials

et al. 2011

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Patients with bone metastases in the extremities sometimes require surgical intervention to prevent deterioration of quality of life due to a pathological fracture. The use of localized radiotherapy combined with surgical reinforcement has been a gold standard for the treatment of bone metastases. However, radiotherapy sometimes induces soft tissue damage, including muscle induration and joint contracture. Moreover, cancer cells are not always radiosensitive. Hyperthermia has been studied since the 1940s using an experimental animal model to treat various types of advanced cancer, and studies have now reached the stage of clinical application, especially in conjunction with radiotherapy or chemotherapy. Nevertheless, bone metastases have several special properties which discourage oncologists from developing hyperthermic therapeutic strategies. First, the bone is located deep in the body, and has low thermal conductivity due to the thickness of cortical bone and the highly vascularized medulla. To address these issues, we developed new hyperthermic strategies which generate heat using magnetic materials under an alternating electromagnetic field, and started clinical application of this treatment modality. The purpose of this review is to summarize the latest studies on hyperthermic treatment in the field of musculoskeletal tumors, and to introduce the treatment strategy employing our novel hyperthermia approach.

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Section: Perspectivesmentioning

confidence: 99%

A novel hyperthermia treatment for bone metastases using magnetic materials

et al. 2011

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“…Various types of sarcomas of the limb from 41 patients who had undergone neoadjuvant RHC and subsequent surgery in the Department of Orthopaedics at Nagoya City University Hospital between 1990 and 1999 were studied. Of these, 31 soft tissue sarcomas were included in our previous report 7 lacking a detailed pathological examination of post‐RHC tumour tissues. Ten bone tumours treated similarly were newly added.…”

Section: Methodsmentioning

confidence: 99%

“…Preoperative neoadjuvant treatments such as chemotherapy, radiotherapy, hyperthermia or a combination of these methods have been increasingly reported 1–6 . We have also performed radio‐hyperthermo‐chemotherapy (RHC) before surgery for high‐grade soft tissue sarcomas of the limb and have reported excellent clinical results, where the effectiveness of RHC was determined by magnetic resonance imaging 7 . However, with the experience of more cases, including bone sarcoma and extension of the follow‐up period, we have noted that even tumours with a good response to RHC may show recurrence and/or metastasis and ultimately a fatal course.…”

Section: Introductionmentioning

confidence: 99%

Proliferation and apoptosis of tumour cells before and after neoadjuvant therapy for high‐grade extremity sarcomas: divergent associations with tumour response and prognosis

Matsubara

Eimoto²,

Okabe³

et al. 2008

Histopathology

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“…Nevertheless, the regimen resulted in an excellent pCR rate of 50% and a local tumour control rate of 88% in deep, high-grade soft tissue sarcomas of the extremities (88%) and trunk, all greater than 5 cm maximal diameter. Otsuko et al [32] tried to improve local disease control and increase survival in high-grade soft tissue sarcoma with preoperative radiotherapy, 32 Gy total dose, directly followed by hyperthermia and intraarterial chemotherapy (cisplatin, pinorubin) once a week. The resection was carried out 2-4 weeks after additional systemic therapy with etoposide/adriamycin/cisplatin intravenously and ifosfamide intraarterially.…”

Section: Sarcomamentioning

confidence: 99%

Current and Potential Role of Thermoradiotherapy for Solid Tumours

et al. 2003

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The disappointing results for inoperable, locally advanced or recurrent solid tumours of the uterine cervix, rectum, chest wall, liver and deep seated, high-risk sarcomas after conventional radiotherapy alone necessitate the search for improved treatments. A benefit from simultaneous radiochemotherapy with regard to local tumour control and survival has been shown for a rising number of tumour entities. Radiofrequency hyperthermia is established in only a few centres, and represents another option to intensify the effect of radio- and chemotherapy. Altogether 11 randomised phase III trials with more than 1,000 patients proved the combination of hyperthermia (40–42 °C for at least 1 h) and radiation therapy in reference to local tumour control. Two of these trials could demonstrate a survival benefit; e.g. in locally advanced cervical cancer, stage FIGO IIB–IVa, the 3-year survival was improved from 27 to 51% with the addition of hyperthermia. Frequently trial design (main endpoint local tumour control), a low number of patients or a short follow- up period are the reasons why most trials of thermoradiotherapy failed to demonstrate a survival benefit. Disadvantageous effects of hyperthermia like an increased rate of distant metastases as a result of hyperthermia-induced elevated perfusion can be largely ruled out. While at the moment the equivalence of thermoradiotherapy and radiochemotherapy is still under evaluation, future studies have to investigate the question whether hyperthermia can add benefits when used in combination with simultaneous radiochemotherapy. An ongoing investigation of hyperthermia in multimodal treatment strategies for locally advanced solid tumours is warranted. These trials will help to improve temperature monitoring and temperature distribution and define particular groups of patients who will profit from the addition of hyperthermia. The ‘Interdisziplinäre Arbeitsgruppe Hyperthermie’, a working group of the German Cancer Society, introduces clinical protocols, treatment devices, and provides information for patients at www.hyperthermie.org.

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Results of surgery and radio-hyperthermo-chemotherapy for patients with soft-tissue sarcoma

Abstract: RHC is currently the most potent and relatively safe treatment method for high-grade soft-tissue sarcomas that is available clinically.

Cited by 26 publications

References 30 publications

A novel hyperthermia treatment for bone metastases using magnetic materials

A novel hyperthermia treatment for bone metastases using magnetic materials

Proliferation and apoptosis of tumour cells before and after neoadjuvant therapy for high‐grade extremity sarcomas: divergent associations with tumour response and prognosis

Current and Potential Role of Thermoradiotherapy for Solid Tumours

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