Locoregional hyperthermia therapy is a, compared to whole-body hyperthermia, more gentle hyperthermia therapy of the tumors of cancer patients, in which cancer cells can be destroyed by exposure to heat. In modern oncology (science that deals with cancer), hyperthermia is usually not used alone, but in combination with radiotherapy and/or chemotherapy.
Mechanisms of action of hyperthermia (HT)
The effect of hyperthermia therapy is essentially based on a direct hyperthermic cytotoxicity (” property to act as a cytotoxin “. Furthermore, the procedure is used in the sense of a radiosensitizer, which after its administration selectively increases the sensitivity of malignant (malignant) cells to ionizing radiation: The effect of hyperthermia is that it makes tumor cells more sensitive with respect to the actual cancer treatment – this applies to both radiotherapy (radiatio) and chemotherapy. Immunomodulation (alteration of the body’s defense system) is another effect of hyperthermia: heat shock proteins (e.g., HSP 70) activate natural killer cells (NK cells), phagocytes (scavenger cells) such as granulocytes (white blood cells), and also dendritic cells (present antigens, especially the T lymphocyte).
Indications (areas of application)
- Bladder carcinoma (cancer of the urinary bladder)
- Cervical carcinoma (cancer of the cervix)
- Brain tumors
- Bone tumor, bone metastases
- Head and neck tumors and their often very large lymph node metastases.
- Malignant germ cell tumors
- Malignant melanoma (“black skin cancer”)
- Mammary carcinoma (breast cancer)
- Localized and advanced breast carcinoma.
- With local recurrence (recurrence of tumor at a previously treated site).
- Ovarian cancer (ovarian cancer).
- Prostate carcinoma (prostate cancer)
- Rectal cancer (rectal cancer) and a rectal cancer recurrence (recurrence of rectal cancer).
- Sarcoma – soft tissue sarcoma
The procedure
The prerequisite for the development of locoregional hyperthermia therapy was, as in the case of whole-body treatment, the fact that in cancer patients with fever, a decrease in cancer cells – that is, a heat sensitivity of the cells – could be detected, but on a hyperthermia area limited to about 15-30 cm of body surface is much less strenuous for the patient to perform. The heat sensitivity of cancer cells is the basis of hyperthermia therapy:
- Halogen light passed through water heats the body under a light anesthesia – usually with the exception of the head – to about 42 °C over a longer period of time in several treatment steps. The effect of hyperthermia depends essentially on the temperature reached: from 42.5 ° C, the overheating has a cytotoxic effect, that is, cell-killing.
In order not to overload the circulation by the high, fever-like heat, the patient usually receives supplemental oxygen and is monitored by electrocardiogram (ECG). Hyperthermia therapy is a complementary therapy, which is carried out in addition to surgery or chemotherapy – or as the only therapeutic measure. Hyperthermia is used for locally advanced tumors, i.e. tumors that grow beyond the respective organ, which are not operable and which cannot be sufficiently cured by radiotherapy or chemotherapy. Many tumors can be reduced in size, and in some cases the survival time of patients is extended. Most centers combine hyperthermia with radiotherapy or chemotherapy. Further notes
- In patients with soft tissue sarcomas, deep hyperthermia combined with preoperative and postoperative chemotherapy improves long-term survival compared with chemotherapy alone.
- Patients with advanced ovarian cancer who did not receive primary surgery benefited from hyperthermia treatment (heating with intraperitoneal perfusion) after neoadjuvant chemotherapy (to reduce tumor mass before surgery; cisplatin at a dose of 100 mg/m2 body surface area):
- Women with hyperthermia were still 14.2 months without recurrence (recurrence of the tumor) versus group of women who had only surgery were a median of 10.7 months without recurrence.
- After a median follow-up of 4.7 years, 61 (50%) had died in the group of women with hyperthermic therapy versus group of those who had been operated on exclusively, here 76 (62%) had died.
- In patients with breast carcinoma (breast cancer) and local recurrence (recurrence of tumor at a previously treated site) thermo-radiotherapy (combination of hyperthermia and radiotherapy) improved the treatment outcome: with thermo-radiotherapy, more than 65% achieved a complete response (complete response to therapy) versus about 40% with radiotherapy alone.
Benefit
If classical cancer therapy has failed for you or you are looking for a complementary treatment method, local hyperthermia therapy offers you another good option.
