The role of hyperthermia in optimizing tumor response to regional therapy

Figures & data

Figure 1. Thermal effects on tumor and cell physiology.

Table I.  Randomized trials assessing the efficacy of hyperthermia.

Tumor	Trial	Year	Patients	Therapy	End point	Effect without HTHT	Effect with HT	P-value
Melanoma	Ghussen et al.	1988	107	OR	Disease free survival	52%	89%	0.0001
				OR + HILP	Overall survival	86.2%	98.1%	0.03
Melanoma	EORTC 18832	1998	832	OR	In-transit metastases	6.6%	3.3%	NR
				OR + HILP	LN metastases	16.7%	12.6%	NR
					Overall survival	76.7%	75.9%	NS
Melanoma	Overgaard et al.	1995	70	RT	Complete response	35%	62%	0.0015
				RT + HT	2-year local control	28%	46%	0.023
Sarcoma	EORTC 62961	2007	341	CT/RT/OR	Local progression free survival	23.7 m	45.3 m	0.01
				CT/RT/OR + HT	Disease free survival	16.2 m	31.7 m	0.004
Breast	ICHG	1996	306	RT	Local response	41%	59%	<0.001
				RT + HT	Local failure	31%	17%	0.007
					2-year survival	30.4%	28.0%	NS
Glioblastoma	Sneed et al.	1998	68	OR + RT	Time to progression	33 w	49 w	0.04
				OR + RT + HT	2-year survival	15%	31%	0.04
Squamous cell cancer - head and neck	Valdagni et al.	1988	41	RT	5-year nodal control	24%	69%	0.015
				RT + HT	5-year survival	0%	53%	0.02
Squamous cell	Sugimachi et al.	1995	66	CR	Complete response	5.9%	25%	<0.05
cancer-esophageal				CR + HT	3-year survival	24.2%	50.4%	NR
Gastric	Nauta et al.	1994	293	OR	3-year survival	35.5%	57.6%	<0.05
				OR + RT	5-year survival	30.1%	51.4%	<0.05
				OR + RT + HT
Gastric	Fujimoto et al	1998	141	OR + CT	Peritoneal recurrence	16	1	<0.0001
				OR/HIPEC + CT	8-year survival	49%	62%	0.036
Pelvic tumors*	Van der Zee et al.	2000	358	RT	Complete response	39%	55%	<0.001
				RT + HT	3-year survival	30%	24%	NS**
Bladder	Colombo et al.	2003	83	OR + IVC	Local recurrence	57.5%	17.1%	0.002
				OR + IVTC
Colorectal Carcinomatosis	Verwaal et al.	2003	105	CT	Median survival	12.6 m	22.3 m	0.032
				CT + OR/HIPEC

CR, chemoradiotherapy; CT, chemotherapy; HILP, hyperthermic isolated limb perfusion; HIPEC, hyperthermic intraperitoneal chemotherapy; HT, hyperthermia; IVC, intravesicular chemotherapy; IVTC, intravesicular thermochemotherapy; NR, not reported; NS, not significant; OR, surgical excision; RT, radiation therapy. *Pelvic tumors - consists of bladder, rectal, and cervical cancer. **Cervical cancer showed a 3 year survival advantage of 51% vs. 27% (p-value 0.009).