Clinical Experience in the Combination of Hyperthermia with Chemotherapy or Radiotherapy

Abstract

Clinical studies into the effect of hyperthermia alone or in combination with other treatment modalities are now being pursued at many centres. Many different techniques of heat delivery are being investigated. The majority of clinical studies have concentrated on the treatment of superficial tumours with localised hyperthermia. The reason for this is that in general there are still technical problems in heating deep-seated tumours and whole-body hyperthermia is both difficult and potentially dangerous. There are now many controlled studies comparing radiation alone with radiation and hyperthermia. There are many differences between these series, notably in radiation dose and temperatures achieved, but an increase in the response rate of tumours treated with the combined modality is almost universal (Overgaard 1984). The majority of such studies have demonstrated an increase in both partial and complete response rates, in most cases not at the expense of increased toxicity. There have been some reports of an increase in severe skin reactions which may be related to the radiation dose used and the interval between the two modalities (Arcangeli et al. 1983; Howard et al. 1987). It has also been suggested that toxicity may be related to the temperature gradient across the tumour (Dewhirst et al. 1984).