Deep hyperthermia with the HYPERcollar system combined with irradiation for advanced head and neck carcinoma – a feasibility study

Figures & data

Figure 1. Different views of the HYPERcollar, the clinical setup and an example simulated SAR pattern on top of a CT scan.

Figure 2. Example of intra-tumor thermometry catheters in the base of tongue.

Table 1. Patient, tumor and treatment characteristics.

Total	27
Sex (n (%))
Males	17 (63)
Females	10 (37)
Age (median (range))
Total	60 (17–85)
Males	60 (17–85)
Females	61 (38–81)
Prior chemotherapy (n (%))	5 (18)
Prior surgery (n (%))	3 (11)
Indications (n (%))
Locally advanced	9 (33)
Re-irradiation	18 (67)
Tumorsite
Head central (n (%))
Sinonasal	3 (11)
Nasopharynx	5 (19)
Head caudal (n (%))
Oral cavity	3 (11)
Oropharynx	10 (37)
Neck (n (%))
Larynx	5 (19)
Trachea	1 (4)
RT technique (n (%))
IMRT	19 (70)
CBK	7 (26)
BT	1 (4)

BT: brachytherapy; CBK: Cyberknife; IMRT: intensity-modulated radiotherapy.

Table 2. Thermometry, toxicity and response data of included patients.

Parameter
HT treatments (n)	119
Incomplete (n (%))	15 (13)
Applied power (Watt) (median (range))	543 (120–1007)
60 minute hyperthermia (median (range))	464 (120–910)
75 minute hyperthermia (median (range))	595 (171–1007)
Estimated SAR (Watt/kg) (median (range))	72.6 (12.0–181.0)
60 minute hyperthermia (median (range))	60.7 (12.0–181.0)
75 minute hyperthermia (median (range))	81.8 (27.9–158.5)
Maximum measured target temperature per patient
Total group (median (range))	40.7 (38.1–42.3)
60 minute hyperthermia (median (range))	40.8 (40.0–42.3)
75 minute hyperthermia (median (range))	39.4 (38.1–40.8)
Median measured temperature per patient (T50)
Total group (median (range))	38.8 (37.8–39.3)
60 minute hyperthermia (median (range))	39.0 (37.8–39.3)
75 minute hyperthermia (median (range))	38.2 (37.9–38.5)
Maximum measured temperature per tumor group
Head central (median (range))	39.0 (38.1–40.0)
Head caudal (median (range))	40.8 (40.7–42.3)
Neck (median)	40.6^a
Tracheostomia (n (%))	2 (7)
Metal implants in CTV (n (%))	2 (7)
Dental fillings in CTV (n (%))	3 (11)
Catheters interstitial (n (%))	16 (59)
Response (%)	59
PR (n (%))	2 (7)
CR (n (%))	14 (52)

^a 1 patient with measured temperatures in the tumor. CR: complete response; CTV: clinical target volume; HT: hyperthermia; PR: partial response; SAR: specific absorption rate.

Figure 3. Example of complete response after combined hyperthermia and irradiation in a cT4N0M0 carcinoma of the base of tongue.

Table 3. Response and survival of included patients.

Response after 3 months (n (%))		59
PR		2 (7)
CR		14 (52)
CR locally advanced HNC		7 (78)
CR recurrent HNC		7 (39)
CR PORT		3 (100)
CR no-PORT		11 (46)
		1 year	2 year
LC (%)
Total		55	40
PORT (3 pts)		100	100
no-PORT (24 pts)		49	32
OS (%)
Total		59	44
PORT (3 pts)		100	67
no-PORT (24 pts)		54	42
Locally advanced HNC (9 pts) (%)
LC		75	50
OS		67	67
Recurrent HNC (18 pts) (%)
LC		45	36
OS		56	33

CR: complete response; LC: local control; OS: overall survival; PR: partial response; PORT: post-operative radiotherapy.