RF-power and temperature data analysis of 444 patients with primary cervical cancer: Deep hyperthermia using the Sigma-60 applicator is reproducible

Figures & data

Table I.  The number of primary cervical cancer patients/treatments as analyzed in this study, per weight-group and time-period, in which the Sigma-60 applicator and four configurations of the BSD-2000 system used by the Rotterdam Hyperthermia Group from 1991 to 2005.

BSD-2000 configuration connected to the Sigma-60	Time-period	Weight-group *	No. patients	No. treatments
BSD-2000 with Quad amplifier	March 1991–May 1998	W<61 kg	45	180
		61 ≤ W ≤ 70 kg	25	105
		W > 70 kg	35	146
			Sum: 105	Sum: 431
BSD-2000-3D with Quad amplifier	June 1998–May 1999	W < 61 kg	23	63
		61 ≤ W ≤ 70 kg	6	14
		W > 70 kg	10	28
			Sum: 39	Sum: 105
BSD-2000-3D with Quad amplifier and 3D drawer, which divides the four channels into 12 channels	June 1999–July 2000	W < 61 kg	20	78
		61 ≤ W ≤ 70 kg	14	64
		W > 70 kg	14	61
			Sum: 48	Sum: 203
BSD-2000-3D with Dodek solid- state amplifier	August 2000–December 2005	W < 61 kg	83	248
		61 ≤ W ≤ 70 kg	84	351
		W > 70 kg	85	334
			Sum: 252	Sum: 933
			Total: 444	Total: 1672

Note: * Weight-groups are based on the 33 and 66 percentile of weight of all patients.

Table II.  Average values of patients’ characteristics, RF-power, and temperature data per treatment.

																	Temperature indices
																	T90 (°C)		T50 (°C)
BSD	WG@	No. pts.	No. trts.	Age (yrs.)	Weight (kg)	Pelvic area (cm^2)	Mean forward power (W)	Max forward power (W)	Mean net power (W)	Mean net integrated power (kJ)	Mean net power per weight (W kg^−1)	Mean net power per pelvic area (W cm^−2)	Mean net integrated power per weight (kJ kg^−1)	Mean net integrated power per pelvic area (kJ cm^−2)	No. switched -off (times/ treatment session)	Total switched -off time (s)	Vagina lumen	All lumina	Vagina lumen	All lumina	CEM 43°C T90 (min)
Panel A
I	I	45	180	55.8	52.8	532	549*	676*	510*	2546*	9.7	0.99	48.2*	5.0	2.9	248	39.6	39.9	40.4	40.7	1.4
				(13.0)	(5.6)	(124)	(132)	(184)	(117)	(805)	(2.1)	(0.3)	(14.5)	(1.8)	(3.0)	(263)	(0.9)	(0.7)	(0.9)	(0.7)	(1.4)
	II	25	105	54.2	66.9	640	722	903	648	3480	9.7	1.04	52.1*	5.6*	2.4	180	39.6	39.9	40.3	40.6	1.4
				(14.9)	(2.9)	(113)	(136)	(193)	(125)	(746)	(1.8)	(0.3)	(11.1)	(1.5)	(2.3)	(190)	(0.9)	(0.7)	(0.9)	(0.6)	(1.4)
	III	35	146	56.8	79.5	733	734	912	647	3420	8.2*	0.90*	43.2	4.8	3.0	199	39.3*	39.7*	40.0*	40.4*	0.9*
				(13.8)	(8.0)	(120)	(139)	(192)	(115)	(687)	(1.5)	(0.2)	(8.7)	(1.1)	(2.6)	(229)	(0.8)	(0.6)	(0.9)	(0.7)	(1.0)
Panel B
II	I	23	63	58.5	55.2	528	614*	767*	511*	2675*	9.3	0.98	48.8	5.1	5.1	290	39.5	39.8	40.1	40.5	1.2
				(12.1)	(4.9)	(57)	(108)	(118)	(105)	(591)	(2.1)	(0.2)	(12.1)	(1.4)	(3.0)	(278)	(0.9)	(0.7)	(0.8)	(0.7)	(1.4)
	II	6	14	51.8	67.9	631	781	962	659	3541	9.7	1.04	51.6	5.6	3.6	152	39.5	40.0	40.0	40.5	1.1
				(8.6)	(2.6)	(43)	(191)	(249)	(172)	(1192)	(2.3)	(0.3)	(16.6)	(1.8)	(2.7)	(196)	(0.7)	(0.7)	(0.8)	(0.8)	(1.0)
	III	10	28	62.2	79.9	749	840	1048	691	3464	8.7	0.95	43.7	4.7	4.9	233	39.3	39.6	40.0	40.3	0.8
				(12.2)	(13.3)	(155)	(131)	(166)	(126)	(937)	(1.4)	(0.2)	(10.9)	(1.4)	(2.8)	(247)	(0.7)	(0.6)	(0.8)	(0.7)	(0.7)
Panel C
III	I	20	78	52.1	55.0	529	682	844	595	3047	10.8*	1.15*	55.7*	5.9	7.4	273	39.3	39.9	40.2	40.6	1.1
				(15.7)	(3.8)	(82)	(101)	(151)	(93)	(613)	(1.8)	(0.3)	(11.5)	(1.5)	(5.0)	(214)	(0.6)	(0.5)	(0.7)	(0.6)	(0.9)
	II	14	64	56.7	66.6	590	680	828	583	2993	8.8	1.03*	45.2	5.3	7.8	290	39.4	39.8	40.1	40.5	1.1
				(14.4)	(2.8)	(91)	(169)	(206)	(148)	(812)	(2.3)	(0.4)	(12.5)	(1.9)	(5.2)	(230)	(0.8)	(0.7)	(0.8)	(0.7)	(1.0)
	III	14	61	63.7	80.2	783	783*	970*	657*	3363*	8.3	0.86*	42.3	4.4*	7.3	254	39.3	39.7	39.9	40.2*	0.8
				(13.3)	(9.1)	(137)	(108)	(155)	(100)	(794)	(1.5)	(0.2)	(10.8)	(1.3)	(5.4)	(231)	(0.8)	(0.6)	(0.7)	(0.7)	(0.8)
Panel D
IV	I	83	248	58.4	55.7	538	628*	812	547*	2689*	9.9*	1.03*	48.6*	5.1*	10.2*	399	39.6*	39.9*	40.4*	40.7*	1.4*
				(15.2)	(5.0)	(95)	(130)	(192)	(117)	(743)	(2.1)	(0.3)	(13.4)	(1.6)	(5.5)	(293)	(0.9)	(0.7)	(0.9)	(0.7)	(1.1)
	II	84	351	55.9	66.0	610	670*	836	579*	2859*	8.8*	0.97*	43.4*	4.8*	12.4	432	39.4	39.7	40.2	40.5*	1.1*
				(16.0)	(2.7)	(105)	(111)	(151)	(103)	(624)	(1.6)	(0.2)	(9.5)	(1.3)	(5.9)	(260)	(0.8)	(0.6)	(0.8)	(0.6)	(1.0)
	III	85	334	57.7	82.8	763	745*	927*	627*	3091*	7.6*	0.84*	37.6*	4.1*	11.7	396	39.4	39.6	40.0	40.3*	0.9*
				(13.4)	(9.4)	(138)	(142)	(185)	(119)	(737)	(1.4)	(0.2)	(8.9)	(1.1)	(5.4)	(212)	(0.8)	(0.7)	(0.8)	(0.7)	(0.8)

Notes: The results are summarized per weight-group for configurations 1–4 of the BSD-2000 hyperthermia system in Panel A–D, respectively. Numbers in parentheses show 1 SD. @Weight Group: I: W < 61 kg, II: 61 ≤ W ≤ 70 kg, III: W > 70 kg. * Statistical significant different from the other values in the same column.

Figure 1. Average of (a) net integrated power, (b) net integrated power per weight, and (c) vagina T₅₀ in the three weight-groups treated with the four configurations of the BSD-2000 and Sigma-60 applicator.

Table III.  Average values of patients’ characteristics, RF-power, and temperature data per treatment for the four configurations of the BSD-2000.

																Temperature indices
																T90 (°C)		T50 (°C)
BSD	No. pts.	No. trts.	Age (yrs.)	Weight (kg)	Pelvic area (cm^2)	Mean forward power (W)	Max. forward power (W)	Mean net power (W)	Mean net integrated power (kJ)	Mean net power per weight (W kg^−1)	Mean net power per pelvic area (W cm^−2)	Mean net integrated power per weight (kJ kg^−1)	Mean net integrated power per pelvic area (kJ cm^−2)	No. switched–off (times/treatment session)	Total switched -off time (s)	Vagina lumen	All lumina	Vagina lumen	All lumina	CEM 43°C T90 (min)
I	105	431	55.7	65	623	647*	803*	585	3042	9.2	0.97	47.6	5.0	2.8*	214*	39.5	39.8	40.3	40.6	1.3
			(13.7)	(13)	(148)	(163)	(221)	(138)	(877)	(2.0)	(0.3)	(12.5)	(1.6)	(2.8)	(236)	(0.9)	(0.7)	(0.9)	(0.7)	(1.3)
II	39	105	58.6	63.5	601	696	868	578	2981	9.2	0.98	47.9	5.1	4.9*	256*	39.4	39.8	40.0	40.4	1.1
			(12)	(13.3)	(133)	(163)	(198)	(146)	(871)	(2.0)	(0.2)	(12.7)	(1.5)	(2.9)	(263)	(0.8)	(0.7)	(0.8)	(0.7)	(1.2)
III	48	203	57.1	66.2	624	711	876	610	3125	9.4	1.03	48.6	5.3	7.5*	273*	39.5	39.8	40.1	40.4	(1.0)
			(15.3)	(11.8)	(149)	(135)	(181)	(118)	(744)	(2.2)	(0.3)	(13.0)	(1.7)	(5.2)	(224)	(0.8)	(0.6)	(0.8)	(0.6)	(0.9)
IV	252	933	57.3	69.1	645	684	861	587	2889*	8.7*	0.94*	42.8*	4.6*	11.5*	410*	39.5	39.7	40.2	40.5	1.1
			(14.9)	(12.6)	(148)	(136)	(182)	(117)	(723)	(1.9)	(0.2)	(11.4)	(1.4)	(5.7)	(254)	(0.8)	(0.7)	(0.8)	(0.7)	(1.0)

Note: *Statistical significant different from the other values in the same column. Numbers in parentheses show 1 SD.

Figure 2. Averages of (a) net integrated power, (b) net integrated power per weight, and (c) vagina T₅₀, in primary cervical cancer patients for the three weight-groups (WG I: W < 61 kg, WG II: 61 ≤ W ≤ 70 kg, WG III: W > 70 kg).

Table IV.  Average values of patients’ characteristics, RF-power, and temperature data per treatment for the three weight-groups. Numbers in parentheses show 1 SD.

																Temperature indices
																T90 (°C)		T50 (°C)
WG@	No. pts.	No. trts.	Age (yrs.)	Weight (kg)	Pelvic area (cm^2)	Mean forward power (W)	Max. forward power (W)	Mean net power (W)	Mean net integrated power (kJ)	Mean net power per weight (W kg^−1)	Mean net power per pelvic area (W cm^−2)	Mean net integrated power per weight (kJ kg^−1)	Mean net integrated power per pelvic area (kJ cm^−2)	No. switched–off (times/treatment session)	Total switched -off time (s)	Vagina lumen	All lumina	Vagina lumen	All lumina	CEM 43°C T90 (min)
I	171	569	56.8	54.6	533	609*	768*	538*	2686*	9.9*	1.03	49.4*	5.2	7.0*	322	39.6	39.9*	40.3*	40.6*	1.3*
			(14.4)	(5.2)	(100)	(132)	(189)	(116)	(747)	(2.1)	(0.3)	(13.6)	(1.6)	(5.6)	(280)	(0.9)	(0.7)	(0.9)	(0.7)	(1.2)
II	129	534	55.6	66.3	614	684*	852*	596*	3013*	9.0*	0.99	45.5*	5.0	9.7*	358	39.5	39.8*	40.2*	40.5*	1.1*
			(15.4)	(2.8)	(105)	(129)	(173)	(119)	(733)	(1.8)	(0.2)	(11.0)	(1.4)	(6.6)	(265)	(0.8)	(0.7)	(0.8)	(0.6)	(1.1)
III	144	569	58.4	81.5	757	751*	934*	638*	3216*	7.9*	0.86*	39.8*	4.3*	8.8*	324	39.3*	39.7*	40.0*	40.3*	0.9*
			(13.6)	(9.4)	(135)	(139)	(185)	(117)	(755)	(1.5)	(0.2)	(9.5)	(1.1)	(6.1)	(237)	(0.8)	(0.7)	(0.8)	(0.7)	(0.9)

Notes: ^@WG: Weight-group; I: W < 61 kg, II: 61 ≤ W ≤ 70 kg, III: W > 70 kg. *Statistical significant different from the other values in the same column.

Table V.  Average values of patients’ characteristics, RF-power, and temperature data per treatment over the 15 years application of loco-regional deep hyperthermia by the Rotterdam Hyperthermia Group.

																	Temperature indices
																	T90 (°C)		T50 (°C)
Time-period	Year	No. pts.	No. trts.	Age (yrs.)	Weight (kg)	Pelvic area (cm^2)	Mean forward power (W)	Max. forward power (W)	Mean net power (W)	Mean net integrated power (kJ)	Mean net power per weight (W kg^−1)	Mean net power per pelvic area (W cm^−2)	Mean net integrated power per weight (kJ kg^−1)	Mean net integrated power per pelvic area (kJ cm^−2)	No. switched–off (times/treatment session)	Total switched -off time (s)	Vagina lumen	All lumina	Vagina lumen	All lumina	CEM 43°C T90 (min)
Study time-period	1991	2	6	56.0	62.3	641	553	664	514	1505	8.4	0.8	23.9	2.3	6.8	447	39.3	39.6	40.2	40.4	0.4
				(7.7)	(8.3)	(73)	(62)	(91)	(61)	(518)	(1.7)	(0.2)	(6.2)	(0.6)	(4.8)	(252)	(0.7)	(0.6)	(0.4)	(0.1)	(0.3)
	1992	6	23	57.5	68.0	670	630	861	578	2448	8.8	0.9	36.8	3.7	7.3	619	38.8	39.0	39.4	39.7	0.4
				(7.3)	(18)	(134)	(142)	(210)	(115)	(609)	(1.9)	(0.2)	(8.3)	(0.7)	(4.2)	(440)	(1.0)	(0.8)	(0.8)	(0.6)	(0.4)
	1993	3	11	44.5	65.7	561	692	856	643	2851	9.9	1.2	41.6	4.9	3.8	273	38.9	39.3	39.3	39.6	0.3
				(10.1)	(8.1)	(79)	(131)	(185)	(124)	(1210)	(1.6)	(0.1)	(17.0)	(1.9)	(2.7)	(287)	(0.5)	(0.5)	(0.4)	(0.3)	(0.2)
	1994	5	17	56.2	66.3	628	604	753	523	2853	7.9	0.8	43.2	4.5	4.8	199	39.4	39.8	40.0	40.4	1.0
				(9.0)	(5.2)	(84)	(152)	(211)	(137)	(697)	(2.0)	(0.2)	(10.3)	(0.9)	(4.2)	(159)	(0.9)	(0.7)	(1.0)	(0.7)	(0.9)
	1995	8	26	51.7	58.4	546	457	567	412	2193	7.1	0.8	37.9	4.2	2.3	238	39.5	39.6	40.1	40.3	1.0
				(14.7)	(8.8)	(126)	(106)	(126)	(98)	(520)	(1.7)	(0.2)	(9.8)	(1.3)	(2.1)	(232)	(0.7)	(0.6)	(0.7)	(0.7)	(0.8)
	1996	17	71	58.6	67.2	626	595	724	529	2861	8.1	0.9	43.5	4.8	1.9	163	39.5	39.8	40.2	40.5	1.3
				(12.6)	(13.8)	(139)	(108)	(175)	(92)	(627)	(1.9)	(0.3)	(10.6)	(1.5)	(1.8)	(172)	(0.8)	(0.6)	(0.8)	(0.7)	(1.6)
Average		6.8	25.7	56	65.9	615	583	728	523	2630	8.2	0.9	40.8	4.4	3.4	266	39.2	39.5	40.0	40.3	1.0
(1991–1996)					(12.2)	(13)	(130)	(137)	(197)	(118)	(732)	(2.0)	(0.2)	(11.2)	(1.4)	(3.4)	(293)	(0.8)	(0.6)	(0.8)	(0.7) (1.3)
Standard	1997	42	182	57.6	64.9	635	671	817	611	3209	9.5	1.0	49.5	5.2	2.1	162	39.7	40.0	40.5	40.8	1.5
time- period				(13.8)	(13.5)	(164)	(164)	(217)	(139)	(906)	(1.7)	(0.2)	(11.6)	(1.5)	(2.0)	(173)	(0.9)	(0.7)	(0.9)	(0.6)	(1.4)
	1998	43	150	54.4	63.1	607	698	882	606	3200	9.7	1.0	51.4	5.4	3.6	237	39.4	39.8	40.1	40.5	1.1
				(15.1)	(12.3)	(139)	(167)	(220)	(141)	(855)	(2.0)	(0.2)	(12.6)	(1.4)	(2.6)	(242)	(0.8)	(0.6)	(0.8)	(0.6)	(1.0)
	1999	46	161	55.8	63.8	592	704	867	602	3103	9.6	1.0	50.1	5.5	6.6	246	39.5	39.8	40.1	40.4	1.0
				(15.3)	(11.5)	(124)	(142)	(171)	(126)	(769)	(2.0)	(0.3)	(12.4)	(1.7)	(4.3)	(221)	(0.8)	(0.7)	(0.8)	(0.7)	(1.0)
	2000	36	156	59.1	66.6	620	716	880	613	3119	9.4	1.0	48.3	5.3	7.8	313	39.5	39.8	40.1	40.5	1.1
				(14.5)	(12.0)	(152)	(141)	(192)	(121)	(770)	(2.3)	(0.3)	(14.0)	(1.6)	(5.4)	(243)	(0.8)	(0.7)	(0.8)	(0.7)	(1.0)
	2001	49	154	54.3	72.5	662	723	903	603	2963	8.5	1.0	42.1	4.7	12.5	379	39.5	39.8	40.2	40.5	1.1
				(15.1)	(14.6)	(151)	(136)	(183)	(102)	(653)	(1.7)	(0.2)	(10.4)	(1.4)	(6.2)	(210)	(0.8)	(0.6)	(0.9)	(0.7)	(1.0)
	2002	50	196	59.6	67.7	636	620	769	518	2577	7.8	0.8	38.6	4.1	12.4	408	39.6	39.8	40.3	40.5	1.2
				(13.6)	(11.2)	(120)	(131)	(173)	(112)	(621)	(1.7)	(0.2)	(9.4)	(1.1)	(6.2)	(260)	(0.8)	(0.6)	(0.8)	(0.6)	(0.9)
	2003	49	187	57.0	69.4	654	694	868	604	2998	8.8	0.9	43.7	4.7	11.0	409	39.5	39.9	40.2	40.6	1.2
				(13.5)	(12.3)	(127)	(123)	(172)	(106)	(666)	(1.5)	(0.2)	(9.2)	(1.0)	(4.9)	(239)	(0.8)	(0.6)	(0.8)	(0.6)	(1.0)
	2004	43	148	54.8	68.9	658	706	902	610	2932	9.0	1.0	43.0	4.8	12.0	422	39.4	39.6	40.2	40.4	1.1
				(15.0)	(10.8)	(202)	(126)	(163)	(113)	(754)	(1.7)	(0.3)	(11.5)	(1.5)	(5.5)	(227)	(0.9)	(0.8)	(0.9)	(0.7)	(1.2)
	2005	45	184	59.5	70.2	654	687	883	603	2946	8.9	0.9	43.8	4.6	11.3	463	39.3	39.5	40.0	40.3	0.9
				(15.7)	(13.8)	(144)	(141)	(184)	(121)	(799)	(2.1)	(0.2)	(12.6)	(1.3)	(5.3)	(302)	(0.8)	(0.7)	(0.9)	(0.7)	(0.9)
Average		44.8	168.7	57	67.5	636	688	860	595	2993	9.0	1.0	45.3	4.9	8.9	341	39.5	39.8	40.2	40.5	1.1
(1997–2005)				(14.7)	(12.8)	(149)	(144)	(191)	(124)	(779)	(2.0)	(0.2)	(12.2)	(1.5)	(6.2)	(258)	(0.8)	(0.7)	(0.8)	(0.7)	(1.1)

Note: Numbers in parentheses show 1 SD.

Figure 3. Average of (a) net integrated power (b), net integrated power per weight, and (c) vagina T₅₀, over the years in primary cervical cancer patients treated with the four configurations of the BSD-2000 and Sigma-60 applicator.

Figure 4. Average frequency of power switched-off and each switched-off duration time per treatment over the 15 years.

Figure 5. Example of correlation between percentages of normalized net integrated power per pelvic area and percentages of normalized vagina T₅₀. The slope of the trend line is 0.16 and the correlation coefficient is 0.9.

Figure 6. Averages of (a) net integrated power and patients’ weight, and (b) vagina lumen T₅₀ and patients’ weight over the last nine years of the study.