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International Journal of Hyperthermia Volume 41, 2024 - Issue 1
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Research Article

Regional hyperthermia for soft tissue sarcoma – a survey on current practice, controversies and consensus among 12 European centers

Siyer Roohania Department of Radiation Oncology, Charité − Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany;b Berlin Institute of Health at Charité, Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité (Junior) Clinician Scientist Program, Berlin, Germany;c Charité − Universitätsmedizin Berlin, Berlin, Germany;d German Cancer Consortium (DKTK), Partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, GermanyCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0002-8232-4994View further author information
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Felix Ehreta Department of Radiation Oncology, Charité − Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany;c Charité − Universitätsmedizin Berlin, Berlin, Germany;d German Cancer Consortium (DKTK), Partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, GermanyORCID Iconhttps://orcid.org/0000-0001-6177-1755View further author information
ORCID Icon,
Marcus Becka Department of Radiation Oncology, Charité − Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyView further author information
,
Danai P. Veltsistaa Department of Radiation Oncology, Charité − Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyView further author information
,
Jacek Nadobnya Department of Radiation Oncology, Charité − Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyView further author information
,
Sebastian Zschaecka Department of Radiation Oncology, Charité − Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany;b Berlin Institute of Health at Charité, Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité (Junior) Clinician Scientist Program, Berlin, GermanyView further author information
,
Sultan Abdel-Rahmane Department of Medicine III, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, GermanyView further author information
,
Franziska Eckertf Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany;g Department of Radiation Oncology, AKH, Comprehensive Cancer Center Vienna, Medical University Vienna, Vienna, AustriaView further author information
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Anne Flörckenc Charité − Universitätsmedizin Berlin, Berlin, Germany;d German Cancer Consortium (DKTK), Partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany;h Department of Hematology, Oncology and Tumor Immunology, Charité − Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, GermanyView further author information
,
Rolf D. Isselse Department of Medicine III, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, GermanyView further author information
,
Stephan Klöcki Department of Radiation Oncology, Lindenhofspital Bern, Bern, SwitzerlandView further author information
,
Robert Krempienj Clinic for Radiotherapy, HELIOS Klinikum Berlin-Buch, Berlin, Germany;k MSB Medical School Berlin, Fakultät für Medizin, Berlin, GermanyView further author information
,
Lars H. Lindnere Department of Medicine III, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, GermanyView further author information
,
Markus Notteri Department of Radiation Oncology, Lindenhofspital Bern, Bern, SwitzerlandView further author information
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Oliver J. Ottl Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen, Germany;m Comprehensive Cancer Center Erlangen-EMN, Erlangen, GermanyView further author information
,
Daniel Pinkn Department of Medical Oncology, Helios Klinikum Bad Saarow, Bad Saarow, Germany;o Cinic for Internal Medicine C - Haematology and Oncology, Stem Cell Transplantation and Palliative Care, University Medicine Greifswald, Greifswald, GermanyView further author information
,
Vlatko Potkrajcicf Department of Radiation Oncology, University Hospital Tübingen, Tübingen, GermanyView further author information
,
Peter Reichardtp Department of Medical Oncology, Helios Klinikum Berlin-Buch, and Medical School Berlin, Berlin, GermanyView further author information
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Oliver Riestererq Center for Radiation Oncology KSA-KSB, Kantonsspital Aarau, Aarau, SwitzerlandView further author information
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Mateusz Jacek Spałekr Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland;s Department of Radiotherapy I, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, PolandView further author information
,
Emanuel Stutzt Department of Radiation Oncology, Inselspital Bern University Hospital, University of Bern, Bern, SwitzerlandView further author information
,
Rüdiger Wessalowskiu Department of Paediatric Haematology and Oncology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, GermanyView further author information
,
Thomas Zilliv Department of Radiation Oncology, Oncology Institute of Southern Switzerland (IOSI), EOC, Bellinzona, Switzerland;w Facoltà di Scienze Biomediche, Università Della Svizzera Italiana (USI), Lugano, Switzerland;x Faculty of Medicine, University of Geneva, Geneva, SwitzerlandView further author information
,
Daniel Zipsa Department of Radiation Oncology, Charité − Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany;c Charité − Universitätsmedizin Berlin, Berlin, Germany;d German Cancer Consortium (DKTK), Partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, GermanyORCID Iconhttps://orcid.org/0000-0001-5779-9675View further author information
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Pirus Ghadjara Department of Radiation Oncology, Charité − Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, GermanyORCID Iconhttps://orcid.org/0000-0002-2747-165XView further author information
ORCID Icon &
David Kaula Department of Radiation Oncology, Charité − Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany;c Charité − Universitätsmedizin Berlin, Berlin, Germany;d German Cancer Consortium (DKTK), Partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, GermanyORCID Iconhttps://orcid.org/0000-0002-7906-5629View further author information
ORCID Icon show all
Article: 2342348 | Received 12 Feb 2024, Accepted 09 Apr 2024, Published online: 23 Apr 2024

Figures & data

Figure 1. Available treatment modalities for STS patients at all participating hyperthermia centers.

Figure 1. Available treatment modalities for STS patients at all participating hyperthermia centers.

Figure 2. Quality assurance guidelines used at centers.

Figure 2. Quality assurance guidelines used at centers.

Figure 3. Treatment aims of RHT. RHT: regional hyperthermia.

Figure 3. Treatment aims of RHT. RHT: regional hyperthermia.

Figure 4. Indications for RHT overall (A), RHT for low-grade tumors (B) and RHT for tumors ≤5cm in size. G: grade; RHT: regional hyperthermia.

Figure 4. Indications for RHT overall (A), RHT for low-grade tumors (B) and RHT for tumors ≤5cm in size. G: grade; RHT: regional hyperthermia.

Figure 5. Chemotherapy and RHT.

Chemotherapy agents combined with RHT (A), total number of chemotherapy cycles concurrent with RHT (B), duration of each RHT with chemotherapy session (C), chemotherapy and RHT timing (C) and weekly chemotherapy with RHT schedule (E). All eight centers applying RHT with chemotherapy responded. CTX = chemotherapy; RHT = regional hyperthermia

Figure 5. Chemotherapy and RHT.Chemotherapy agents combined with RHT (A), total number of chemotherapy cycles concurrent with RHT (B), duration of each RHT with chemotherapy session (C), chemotherapy and RHT timing (C) and weekly chemotherapy with RHT schedule (E). All eight centers applying RHT with chemotherapy responded. CTX = chemotherapy; RHT = regional hyperthermia

Figure 6. Sequence of RHT and chemotherapy (A) and indications for post-op RHT and chemotherapy (B). RHT: regional hyperthermia.

Figure 6. Sequence of RHT and chemotherapy (A) and indications for post-op RHT and chemotherapy (B). RHT: regional hyperthermia.

Figure 7. Radiotherapy and RHT. Radiotherapy with RHT sequence (A), sites for preoperative radiotherapy with RHT (B), indications for postoperative radiotherapy with RHT (C) and number of RHT sessions per week during radiotherapy (D). RHT: regional hyperthermia; RT: radiotherapy.

Figure 7. Radiotherapy and RHT. Radiotherapy with RHT sequence (A), sites for preoperative radiotherapy with RHT (B), indications for postoperative radiotherapy with RHT (C) and number of RHT sessions per week during radiotherapy (D). RHT: regional hyperthermia; RT: radiotherapy.

Figure 8. Contraindications for RHT. RHT: regional hyperthermia.

Figure 8. Contraindications for RHT. RHT: regional hyperthermia.

Figure 9. RHT planning and settings.

Imaging modalities for RHT planning (A), RHT systems in use (B), methods of thermometry (C), intratumoral target temperature (D), maximum temperature accepted in the surrounding healthy tissue (E) and frequency of cardiovascular monitoring during each RHT session (F). CT: computed tomography; MRI: magnetic resonance imaging; RHT: regional hyperthermia.

Figure 9. RHT planning and settings.Imaging modalities for RHT planning (A), RHT systems in use (B), methods of thermometry (C), intratumoral target temperature (D), maximum temperature accepted in the surrounding healthy tissue (E) and frequency of cardiovascular monitoring during each RHT session (F). CT: computed tomography; MRI: magnetic resonance imaging; RHT: regional hyperthermia.
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Data availability statement

Data are available on request from the corresponding author.

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