The clinical feasibility of deep hyperthermia treatment in the head and neck: new challenges for positioning and temperature measurement

Abstract

To apply high-quality hyperthermia treatment to tumours at deep locations in the head and neck (H&N), we have designed and built a site-specific phased-array applicator. Earlier, we demonstrated its features in parameter studies, validated those by phantom measurements and clinically introduced the system. In this paper we will critically review our first clinical experiences and demonstrate the pivotal role of hyperthermia treatment planning (HTP). Three representative patient cases (thyroid, oropharynx and nasal cavity) are selected and discussed. Treatment planning, the treatment, interstitially measured temperatures and their interrelation are analysed from a physics point of view. Treatments lasting 1 h were feasible and well tolerated and no acute treatment-related toxicity has been observed. Maximum temperatures measured are in the range of those obtained during deep hyperthermia treatments in the pelvic region but mean temperatures are still to be improved. Further, we found that simulated power absorption correlated well with measured temperatures illustrating the validity of our treatment approach of using energy profile optimizations to arrive at higher temperatures. This is the first data proving that focussed heating of tumours in the H&N is feasible. Further, HTP proved a valuable tool in treatment optimization. Items to improve are (1) the transfer of HTP settings into the clinic and (2) the registration of the thermal dose, i.e. dosimetry.

Planning of Electroporation-Based Treatments Using Web-Based Treatment-Planning Software

“…This facilitates treatment planning by developing treatment-planning software as a Web application, which allows remote generation of treatment plans (Olsen et al 2000). Moreover, the treatment-planning software should be as automated as possible since without treatment-planning software a clinician (i.e., a medical doctor) may otherwise need about 6 h to manually perform segmentation of a patient (Paulides et al 2010). The advance from treating skin metastases to treating deep-seated tumors would be facilitated by userfriendly treatment-planning software that would allow clinicians to prepare patient-specific treatment plans without the need of an engineer or a medical physicist or specialized engineering knowledge (Pavliha et al 2012).…”

Towards developing effective hyperthermia treatment for tumours in the nasopharyngeal region

“…Treatments performed thus far have shown the feasibility of deep heating by a non-invasive technique using microwaves [16]. Furthermore, we showed that intratumoural temperature measurements in the nasopharynx are challenging but feasible.…”

Thermal Therapy Modalities for Cancer Treatment: A Review and Future Perspectives

“…It is mostly used to treat deep tumors like pelvis or abdomen. This method is more complex than the first one, because of the complexity and nonhomogeneity of the targeted region [39].…”

“…Another method exists based on the use of embedded thermal sensors to measure the temperature. The probe or the invasive heating source is equipped with sensors to measure the temperature locally [2,32,36,39].…”