Sensitivity of hyperthermia trial outcomes to temperature and time: Implications for thermal goals of treatment

Oleson, James R.; Samulski, Thaddeus V.; Leopold, Kenneth A.; Clegg, Sonya M.; Dewhirst, Mark W.; Dodge, Richard K.; George, Stephen L.

doi:10.1016/0360-3016(93)90351-u

Cited by 268 publications

(156 citation statements)

References 19 publications

Supporting

Mentioning

152

Contrasting

Unclassified

Order By: Relevance

“…As prior studies had shown a thermal dose of CEM 43°C T90 (the number of cumulative equivalent minutes at 43°C exceeded by 90% of monitored points within the tumor) equated with improved treatment outcome, (83)(84) hyperthermia was prescribed to either CEM 43°C T90 <1 or CEM 43°C T90 >10. 122 patients were enrolled of which 89% were determined at the time of first hyperthermia treatment to have tumors that could be effectively heated.…”

Section: Breast Cancermentioning

confidence: 99%

“…(104) This parameter, cumulative equivalent minutes at 43°C achieved by 90% of the measured temperate points in the targeted area or CEM43T90, has been shown in multiple studies to correlate with clinical outcome. (83)(84)(105)(106)(107)(108)(109)(110)(111)(112) The field of thermal dosimetry continues to evolve given that most treatment thermal profiles are based on modest samples of temperature points in the heated region. Non-invasive approaches to temperature measurement capable of monitoring hundreds or thousands of points in real time is now possible albeit not widely available.…”

Section: Challenges To Clinical Implementationmentioning

confidence: 99%

See 1 more Smart Citation

Hyperthermia, Radiation and Chemotherapy: The Role of Heat in Multidisciplinary Cancer Care

Hurwitz

Stauffer

2014

Seminars in Oncology

123

104

View full text Add to dashboard Cite

Section: Breast Cancermentioning

confidence: 99%

Section: Challenges To Clinical Implementationmentioning

confidence: 99%

Hyperthermia, Radiation and Chemotherapy: The Role of Heat in Multidisciplinary Cancer Care

Hurwitz

Stauffer

2014

Seminars in Oncology

123

104

View full text Add to dashboard Cite

“…The temperature T x , exceeded by x% (where x = 90, 50) of the measurements, was determined and termed the index temperature [17]. Index temperatures give an indication of the quality of the hyperthermia treatment, like the mean and minimum temperature reached and the temperature heterogeneity.…”

Section: Hyperthermiamentioning

confidence: 99%

Radiotherapy and hyperthermia in the treatment of patients with locally advanced prostate cancer: preliminary results

Vulpen¹,

Leeuw²,

Raaymakers³

et al. 2003

BJU International

View full text Add to dashboard Cite

was delivered using a conformal three-field technique, administering 70 Gy in 2-Gy fractions in 7 weeks. RESULTSThe mean initial prostate-specific antigen level was 26 ng/mL. Three patients had a T4 and 23 a T3 tumour; the tumours were classified as well (four), moderately (16) and poorly (six) differentiated. The mean followup was 36 months. In the combined treatments there was no toxicity of more than grade 2. In regional hyperthermia the mean index temperature (T 90 and T 50 , i.e. exceeded by 90% and 50% of the measurements) was 40.2 ∞ C and 40.8 ∞ C, and for interstitial hyperthermia 39.4 ∞ C and 41.8 ∞ C, respectively. All patients survived; seven patients had a biochemical relapse (27%), three in the regional and four in the interstitial group. The actuarial probability of freedom from biochemical relapse was 70% at 36 months for all patients together, 79% for regional and 57% for interstitial. No factors were found that could be used to predict relapse. CONCLUSIONSThe clinical outcome in these patients with advanced localized prostate cancer seems to compare favourably with most series using irradiation alone, and the treatment caused no severe complications.

show abstract

“…However, currently available hyperthermia devices have been ineffective in raising the temperature of human tumours sufficiently to cause such effects. Furthermore, according to clinical results of thermoradiotherapy, correlations between response to hyperthermia and lowest temperatures in tumours have been reported, and the prognostically important temperatures have been < 41C (Valdagni et al, 1988;Oleson et al, 1993). Therefore, Oleson (1995) suggested that in previous clinical studies in which hyperthermia was shown to improve the effectiveness of radiotherapy, it might have improved tumour On the other hand, it is known that many tumour cells in solid tumours are non-proliferating (quiescent) and it has been shown that plateau-phase cultures in vitro contain large numbers of quiescent (Q) cells (Luk and Keng, 1985).…”

mentioning

confidence: 99%

Reduction of hypoxic cells in solid tumours induced by mild hyperthermia: special reference to differences in changes in the hypoxic fraction between total and quiescent cell populations

Masunaga

Ono²,

Akaboshi³

et al. 1997

Br J Cancer

View full text Add to dashboard Cite

Summary C3H/He mice bearing SCC VII tumours received 5-bromo-2'-deoxyuridine (BrdU) continuously for 5 days via implanted miniosmotic pumps in order to label all proliferating (P) cells. The tumours were then heated at 400C for 60 min. At various time points after heating, tumour-bearing mice were irradiated while alive or after being killed. Immediately after irradiation, the tumours were excised, minced and trypsinized. The tumour cell suspensions obtained were incubated with cytochalasin-B (a cytokinesis blocker), and the micronucleus (MN) frequency in cells without BrdU labelling, which could be regarded as quiescent (Q) cells, was determined using immunofluorescence staining for BrdU. The MN frequency in the total (P+Q) tumour cell population was determined from the irradiated tumours that were not pretreated with BrdU. The MN frequency of BrdU unlabelled cells was then used to calculate the surviving fraction of the unlabelled cells from the regression line for the relationship between the MN frequency and the surviving fraction of total (P+Q) tumour cells. In general, Q cells contained a greater hypoxic fraction (HF) than the total tumour cell population. Mild heating decreased the HF of Q cells more markedly than in the total cell population, and the minimum values of HFs of both total and Q cell populations were obtained 6 h after heating. Two days after heating, the HF of total tumour cells returned to almost that of unheated tumours. In contrast, the HF of Q cells did not return to the HF level of unheated tumours until 1 week after heating. It was thought that irradiation within 12 h after mild heating might be a potentially promising therapeutic modality for controlling radioresistant Q tumour cells.Keywords: quiescent cell; hypoxic fraction; mild hyperthermia; immunofluorescence staining; micronucleus assay; 5-bromo-2'-deoxyuridine Tumour hypoxia is clearly an important problem, and improved patient responses to radiotherapy can be achieved by treatments that overcome tumour radiation resistance resulting from the presence of hypoxic cells (Overgaard, 1989). It has been firmly established that hypoxic cells impair the radiation responsiveness of almost all animal tumours thus far investigated (Coleman, 1988).The effectiveness of hyperthermia as an adjuvant modality to radiotherapy has been demonstrated (Overgaard et al, 1995). Laboratory experiments using animal tumours showed that heating for 30 to 60 min at relatively high temperatures, i.e. > 43 to 44°C, damages intratumour blood vessels and kills tumour cells (Vaupel, 1990). Additionally, hyperthermia causes direct cellular radiosensitization (Dewey, 1994). However, currently available hyperthermia devices have been ineffective in raising the temperature of human tumours sufficiently to cause such effects. Furthermore, according to clinical results of thermoradiotherapy, correlations between response to hyperthermia and lowest temperatures in tumours have been reported, and the prognostically important temperatures have been < 41C (Valdagni et ...

show abstract

Sensitivity of hyperthermia trial outcomes to temperature and time: Implications for thermal goals of treatment

Cited by 268 publications

References 19 publications

Hyperthermia, Radiation and Chemotherapy: The Role of Heat in Multidisciplinary Cancer Care

Hyperthermia, Radiation and Chemotherapy: The Role of Heat in Multidisciplinary Cancer Care

Radiotherapy and hyperthermia in the treatment of patients with locally advanced prostate cancer: preliminary results

Reduction of hypoxic cells in solid tumours induced by mild hyperthermia: special reference to differences in changes in the hypoxic fraction between total and quiescent cell populations

Contact Info

Product

Resources

About