Hyperthermia and radiotherapy in bladder cancer

Figures & data

Figure 1. The hypoxic fraction may be significantly reduced utilising moderate hyperthermia (HT) concurrent with radiotherapy as demonstrated in canine soft tissue sarcomas by Vujaskovic et al. [46] (data replotted with permission). However, temperatures above 44 °C seem to elicit worsening hypoxia.

Figure 2. Treatment workflow for delivering bladder hyperthermia including simulation (a), hyperthermia modelling and planning (b), plan evaluation (c), and deep hyperthermia delivery with temperature monitoring (d). (Reproduced from Datta et al. [54] with permission.)

Table 1. Selected experiences utilising radiation therapy with concurrent hyperthermia in bladder cancer as well as intravesical and systemic therapies.

	Patients	Patients receiving HT	Concurrent radiation dose/Gy per fraction	Additional therapy	HT frequency	Complete response rate with HT (%)	Any response rate with HT (%)	Response rate in patients not receiving HT (%)
Matsui et al. [55]	56	40	40/4	Intravesical bleomycin	Daily	39	84	56 (50–70 Gy)
Takechi et al. [57]	5	5	15/3	Intravesical pirarubicin	Daily	60	60	–
Masunaga et al. [58]	49	28	24/4	–	Twice weekly	29	83	48
Noguchi et al. [59]	35	35	40/4	M-VAC systemic in 17 patients	Twice weekly	23	79%/64 (±M-VAC)	–
Wittlinger et al. [61]	45	45	50.4–59.4/1.8	Cisplatin/5FU systemic	Weekly	96	98	–
Van der Zee et al. [69]	101	52	66–70/2	–	Weekly	73	–	51 (CR)

HT: hyperthermia.

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Wittlinger M, Rödel CM, Weiss C, Krause SF, Kühn R, Fietkau R, et al. Quadrimodal treatment of high-risk T1 and T2 bladder cancer: transurethral tumor resection followed by concurrent radiochemotherapy and regional deep hyperthermia. Radiother Oncol 2009;93:358–63.

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Van der Zee J, González González D, van Rhoon GC, van Dijk JD, van Putten WL, Hart AA. Comparison of radiotherapy alone with radiotherapy plus hyperthermia in locally advanced pelvic tumours: a prospective, randomised, multicentre trial. Dutch Deep Hyperthermia Group. Lancet 2000;355(9210):1119–25.

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