Hyperthermia Combined with Chemotherapy – Biological Rationale, Clinical Application, and Treatment Results

R. Issels

GSF – Forschungszentrum für Umwelt und Gesundheit, Institut für Molekulare Immunologie und Klinikum Großhadern, Medizinische Klinik III

Summary
There is substantial evidence from preclinical data that the
antitumor cytotoxicity of selected chemotherapeutic agents
either alone or combined with radiation can be enhanced by
appropriate heat exposure (40–44 °C) of cells or tumor
tissues. Based upon these results the integration of hyperthermia
as an additional treatment modality, given simultaneously
with systemic chemotherapy or in combination with
radiochemotherapy, is currently tested at the clinic. Regional
hyperthermia combined with chemotherapy or radiochemotherapy
showed impressive results (phase II studies) at
clinical relevant temperatures in locally advanced tumors of
different entities in terms of objective response rate, local
tumor control and relapse-free survival. Clinical protocols of
well-designed phase III trials on combined treatment modalities
integrating hyperthermia are rather limited but for some
tumors confirm its clinical benefit. In general, the clinical
approach to use hyperthermia has gained much more
interest within in the field of medical oncology. One of the
major reason is the substantial technical improvements
made with the available commercial equipment for local or
regional heating, especially in case of deep-seated lesions or
systemic heating. Further testing of the potential of hyperthermia
combined with chemotherapy or radiochemotherapy
in prospective randomized trials are warranted. At this time,
hyperthermia as an adjunct to conventional treatment
strategies is recommended in the setting of clinical protocols.
The results of prospective trials should answer the
question for which types of local advanced or metastatic
tumors hyperthermia becomes standard as part of a multimodal
treatment strategy.

General Hyperthermia With Chemotherapy Review 1999
General Hyperthermia With Chemotherapy Review 1999
General Hyperthermia with Chemotherapy Review 1999.pdf
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