Tumour response to heat and radiation: Prognostic variables in the treatment of neck node metastases from head and neck cancer

Abstract

A total of 38 patients with 81 multiple neck node metastases from squamous cell carcinoma of head and neck were treated with radiotherapy alone or with radiotherapy plus hyperthermia. Irradiation was delivered following a three fractions per day schedule of 2 + 1.5 + 1.5 Gy/day, with 4 h intervals between fractions, up to a total dose of 60 Gy. Heat was applied by means of a 500 MHz apparatus. Temperature data were converted to equivalent minutes at 42.5 degrees (Eq 42.5). Initial complete response rates and local control distribution were compared for subgroups of tumour volume and thermal dose. The data indicated that the volume effect was less pronounced in the combined modality than in the radiation alone arm, suggesting that the addition of heat was more damaging to the large than to the small lesions. A striking thermal dose-response relationship was shown, although complete response rates increased only after a certain thermal dose was accumulated, clearly indicating the presence of a threshold dose.

Relationship between thermal dose and outcome in thermoradiotherapy treatments for superficial recurrences of breast cancer: Data from a phase III trial

“…However, when the animal data were restricted to squamous cell carcinomas, a relationship between thermal dose and duration of local response was found. Arcangeli et al (1,2) have also suggested such a relationship in a nonrandomized trial of hyperthermia as an adjunct to radiation in the treatment of neck node metastases from head and neck cancer. However, we interpret their data to show only an increase in initial response rate and question whether initial complete responders demonstrate any significant difference in kinetics of tumor regrowth or death as a function of thermal dose.…”

Local Hyperthermia, Radiation, and Chemotherapy in Locally Advanced Malignancies

“…In addition, our patients were heavily pretreated. In this regard a review of the available literature would pre dict a CR rate in the range of ~ 30 ± 8% [8][9][10][11] with the combination of RT and HT. Hence, our observed re sponse rate of 19% suggests no obvious benefit to patients with locally progressive sarcoma or squamous-cell carci noma of the head and neck for the addition of cisplatin to thermo-radiotherapy.…”

“…Several groups have stressed the significance of tumor size [4][5][6][7] as a significant prognostic variable. Our review of specific literature [8][9][10][11] suggested that the complete regression (CR) rate drops over 50% for large lesions, such that one would anticipate a CR rate of ~ 30 ± 8% in lesions great er than 7 cm2 or 14 cm3.…”

Phase-I/II-Studie zur lokalen Hyperthermie zervikaler N2/N3-Lymphknotenmetastasen

“…Die perkutane lokale Hyperthermie mit hochfrequenten (Radio-)Wellen ist wenig invasiv und unter ambulanten Bedingungen durchfª [1,12,34]. Dabei kommen verschiedene Hochfrequenzapplikatoren (Antennen) zur Anwendung (Abbildungen la und lb).…”

“…lokaler Kontrolle, wie insbesondere fª Weichteilsarkome [9][10][11], aber auch fª Lymphknotenmetastasen irn Kopf-Hals-Bereich [1,11] gezeigt wurde. Eine systematische Analyse der erzielten Leistungsdichten, Temperaturparameter und klinischen Resultate der Thermotherapie bei zervikalen Lymphknotenmetastasen ist Gegenstand der folgenden Arbeit.…”