Interstitial, Endocavitary and Perfusional Hyperthermia: Methods and Clinical Trials

ISBN-13: 9783642746420 / Angielski / Miękka / 2011 / 90 str.

Michel Gautherie

Opis

"Internal" hyperthermia is a type of thermotherapy by which heat is sup plied to tumor tissue in situ. There are three different techniques for pro viding internal hyperthermia: (1) interstitial hyperthermia using implanted needle probes, (2) intracavitary hyperthermia using probes introduced into natural body cavities, and (3) perfusional hyperthermia by means of ex tracorporal blood heating. Compared with external hyperthermia, internal hyperthermia has been preferentially accepted by oncologists because it can be more easily combined with other forms of treatment, e. g., interstitial thermotherapy with brachytherapy, or perfusional hyperthermia with che motherapy. Various types of equipment for interstitial and intracavitary thermotherapy have been developed and used quite extensively in clinical trials, generally in combination with radiation therapy. There are four different methods for producing interstitial or intracavitary hyperthermia, each related to different types of heating. Most studies have been performed using radiofrequency electrodes (resistive heating) or coaxial microwave antennas (radiative heating). Recently, however, "hot source" techniques that rely on thermal conduction and blood flow convection for heat transport have found clinical application. These techniques include ferromagnetic implants activated by hot water or by electrical means. In the near future, new methods for in terstitial or intraluminal heating based upon advanced ultrasonic and laser technologies will be developed."

Spis treści

1 Interstitial Hyperthermia.- 1.1 Introduction.- 1.2 Physical and Technological Aspects of Interstitial Hyperthermia.- 1.2.1 Resistive Radiofrequency (Low Frequency) Interstitial Heating (RF Technique).- 1.2.1.1 Physical Aspects.- 1.2.1.2 Technological Aspects.- 1.2.2 Radiative Microwave Interstitial Heating.- 1.2.2.1 Physical Aspects.- 1.2.2.2 Technological Aspects.- 1.2.3 Inductively Heated Ferromagnetic Seeds.- 1.2.4 Other Techniques.- 1.2.5 Comparative Study of the Different Techniques for Interstitial Hyperthermia.- 1.2.5.1 Material for the Implantations.- 1.2.5.2 Number of Implanted Electrodes.- 1.2.5.3 Spacing of the Probes.- 1.2.5.4 Length of the Electrodes.- 1.2.5.5 Distribution of the Temperature Around the Probes.- 1.2.5.6 Thermometry.- 1.3 Clinical Aspects of Interstitial Hyperthermia.- 1.3.1 Techniques of Implantation.- 1.3.1.1 Anesthesia.- 1.3.1.2 Techniques of Implantation for Superficial Lesions.- 1.3.1.3 Techniques of Implantation for Head and Neck Primary Tumors.- 1.3.1.4 Techniques of Implantation for Pelvic Tumors.- 1.3.2 Heating Technique.- 1.3.2.1 Patients Awake, With or Without Sedation.- 1.3.2.2 Patients Under General Anesthesia.- 1.3.3 Brachytherapy Technique.- 1.3.4 Treatment Schedule.- 1.3.4.1 What Temperature Should Be Accepted as the “Treatment Temperature”?.- 1.3.4.2 What Is the Optimal Duration of an Interstitial Heat Application?.- 1.3.4.3 What Is the Optimal Number of Interstitial Hyperthermia Sessions?.- 1.3.4.4 External and/or Interstitial Irradiation?.- 1.3.4.5 Which Radiation Dose Should Be Given?.- 1.3.4.6 What Is the Best Sequence?.- 1.3.5 Distribution of Temperatures in Patients.- 1.3.6 Clinical Results.- 1.3.6.1 Influence of Tumor Site.- 1.3.6.2 Influence of Tumor Volume.- 1.3.6.3 Influence of the Quality of Hyperthermia.- 1.3.6.4 Influence of the Combined Radiation Dose.- 1.3.6.5 Respective Impact of the Different Parameters on Clinical Results.- 1.3.6.6 Long-term Tumor Control.- 1.3.7 Toxicity.- 1.4 Future Prospects.- 1.4.1 Development of the Techniques.- 1.4.2 The Search for New Indications: the Example of Interstitial Hyperthermia of Brain Tumors.- 1.4.3 Intraoperative Interstitial Hyperthermia.- 1.4.4 The Need for Randomized Studies.- 1.5 Conclusions.- References.- 2 Hyperthermia in Urology.- 2.1 Introduction.- 2.2 Hyperthermia of the Urinary Bladder.- 2.2.1 Development of the Use of Hyperthermia in Bladder Cancer.- 2.2.2 Animal Experiments on Hyperthermia of the Bladder.- 2.2.3 Hyperthermia as Monotherapy in Bladder Cancer.- 2.2.4 Hyperthermia as Part of an Integrated Combined Treatment in Bladder Cancer.- 2.2.5 Results of Combined Hyperthermia and Locoregional Chemoembolization.- 2.3 Hyperthermia of the Prostate.- 2.3.1 Cancer of the Prostate.- 2.3.2 Benign Hyperplasia of the Prostate.- 2.3.3 Chronic Prostatitis and Prostatodynia.- 2.4 Conclusions.- References.- 3 Experimental and Clinical Studies of Hyperthermia for Carcinoma of the Esophagus.- 3.1 Introduction.- 3.2 Biological Basis for Prescription of the Combination of Hyperthermia, Chemotherapy, and Irradiation.- 3.2.1 Hyperthermo-chemo-radiotherapy for Treating Ehrlich Ascites Tumor in Mice.- 3.2.2 Hyperthermo-chemo-radiotherapy and the Human Esophageal Squamous Cell Line KSE-1.- 3.3 Heat Delivery for Carcinoma of the Esophagus.- 3.3.1 Experiments.- 3.4 Clinical Investigations on the Combination of Hyperthermia, Chemotherapy, and Irradiation for Carcinoma of the Esophagus.- 3.4.1 Histopathological Evaluation.- 3.4.2 Long-term Results.- 3.4.3 Multi-institutional Report.- 3.4.4 Hyperthermia Sensitivity Test.- 3.5 Prospects of Hyperthermia.- References.- 4 Combined Hyperthermia and Chemotherapy for Malignant Melanoma of the Limbs.- 4.1 Concepts and Problems in the Treatment of Malignant Melanomas.- 4.2 Biological Basis of Combined Hyperthermia and Chemotherapy.- 4.3 Treatment Techniques and Protocols.- 4.3.1 Extracorporeal Circulation.- 4.3.2 Hyperthermia (Including Temperature Control).- 4.3.3 Chemotherapy.- 4.4 Clinical Trials and Results: The Strasbourg Experience.- 4.4.1 Technical Characteristics, Selection Criteria, and Exclusion Criteria.- 4.4.2 Complications and Side-effects.- 4.4.3 Results.- 4.5 Discussion and Comments.- 4.5.1 Present Indications and Summary of Clinical Data.- 4.5.2 Future Prospects.- 4.6 Conclusion.- References.