Biomedical Engineering Reference
In-Depth Information
in applying the applicator setup to the patient as well as in the
comfort of the applicator setup for the patient. Graphical user
interfaces have matured to a “one-view” level (i.e., the hyper-
thermia technician is provided instantly with a good and clear
overview of the temperature distribution in the target region).
Thermometry systems have evolved from single points once
per five minutes “emc” interfered measurement to continuous
measuring 8-multi-sensor fiber-optic probes that are “emc”
immune. The ultimate gain in thermometry is obtained in
loco-regional hyperthermia where the development of nonin-
vasive thermometry by magnetic resonance imaging provides
3-dimensional information on the temperature distribution.
This technology is currently being tested for real-time feedback
control to guide the delivery of a “prescribed” thermal dose.
The rapidly growing use of hyperthermia treatment planning
systems will help strongly to advance high-quality application
of hyperthermia treatments. Clearly, for a correct translation of
predicted energy distribution from the monitor to the patient
the patient needs to be precisely positioned, and the phase and
amplitudes at the feed point for all antennas needs to be known
accurately.
Heating tissue for hyperthermia in the coming years remains
a procedure that involves complex technology, physiology, and
biology. The great progress in equipment development has pro-
vided the hyperthermia community with important tools for a
highly controlled quality of the clinical application of hyper-
thermia. This should stimulate physicians, biologists, and physi-
cists to investigate new ways to exploit the potential benefits of
hyperthermia for cancer treatment.
5. Issels, R.D., Lindner, L.H., Verweij, J., Wust, P., Richardt,
P., Schem, B.C., Abdel-Rahman, S., Daugaard, S., Salat, C.,
Wendtner, C.M., Vujaskovic, Z., Wessalowski, R., Jauch,
K.W., Dürr, H.R., Ploner, F., Baur-Melnyk, A., Mansmann,
U., Hiddemann, W., Blay, J.Y., Hohenberger, P. 2010. Neo-
adjuvant chemotherapy alone or with regional hyperthermia
for localised high-risk soft-tissue sarcoma: A randomised
phase 3 multicentre study.
Lancet Oncol
11:561-570.
6. Hua, Y., Ma, S., Fu, Z., Hu, O., Wang, L., Pia, Y. 2010.
Intracavity hyperthermia in nasopharyngeal cancer: A
phase III clinical study.
Int J Hyperthermia
1-7, early online.
7. Van der Zee, J., Van der Holt, B., Rietveld, P.J.M., Helle,
P.A., Wijnmaalen, A.J., Van Putten, W.L.J., Van Rhoon, G.C.
1999. Reirradiation combined with hyperthermia in recur-
rent breast cancer results in a worthwhile local palliation.
Br
J Cancer
79: 483-490.
8. Lee, H.K., Antell, A.G., Perez, C.A., Straube, W.L.,
Ramachandran, G., Myerson, R.J., Emami, B., Molmenti,
E.P., Buckner, A., Lockett, M.A. 1998. Superficial hyper-
thermia and irradiation for recurrent breast carcinoma of
the chest wall: Prognostic factors in 196 tumors.
Int J Radiat
Oncol Biol Phys
40: 365-375.
9. Kapp, D.S. and Cox, R.S. 1995. Thermal treatment parameters
are most predictive of outcome in patients with single tumor
nodules per treatment field in recurrent adenocarcinoma of the
breast [see comments].
Int J Radiat Oncol Biol Phys
33 887-899.
10. Oleson, J.R., Samulski, T.V., Leopold, K.A., Clegg, S.T.,
Dewhirst, M.W., Dodge, R.K., George, S.L. 1993. Sensitivity
of hyperthermia trial outcomes to temperature and time:
Implications for thermal goals of treatment.
Int J Radiat
Oncol Biol Phys
25: 289-297.
11. Sherar, M., Liu, F.F., Pintilie, M., Levin, W., Hunt, J., Hill,
R., Hand, J., Vernon, C., Van Rhoon, G.C., Van der Zee, J.,
Gonzalez, D.G., Van Dijk, J., Whaley, J., Machin, D. 1997.
Relationship between thermal dose and outcome in ther-
moradiotherapy treatments for superficial recurrences of
breast cancer: Data from a phase III trial.
Int J Radiat Oncol
Biol
Phys
39: 371-380.
12. Thrall, D.E., LaRue, S.M., Yu, D., Samulski, T., Sanders, L.,
Case, B., Rosner, G., Azuma, C., Poulson, J., Pruitt, A.F.,
Stanley, W., Hauck, M.L., Williams, L., Hess, P., Dewhirst,
M.W. 2005. Thermal dose is related to duration of local
control in canine sarcomas treated with thermoradiation-
therapy.
Clin Cancer Res
11: 5206-5214.
13. Maguire, P.D., Samulski, T.V., Prosnitz, L.R., Jones, E.L.,
Rosner, G.L., Powers, B., Layfiels, L.W., Brizel, D.M., Scully,
S.P., Harrelson, J.M., Dewhirst, M.W. 2001. A phase II trial
testing the thermal dose parameter CEM43°T90 as a predic-
tor of response in soft tissue sarcomas treated with pre-oper-
ative thermoradiotherapy.
Int J Hyperthermia
17: 283-290.
references
1. Van der Zee, J., Vujaskovic, Z., Kondo, M., Sugahara, T.
2008. The Kadota Fund International Forum 2004—clinical
group consensus.
Int J Hyperthermia
24: 111-122.
2. Van der Zee, J., González, D., Van Rhoon, G.C., Van Dijk,
J.D.P., Van Putten, W.L.J., Hart, A.A.M. 2000. For the Dutch
Deep Hyperthermia Group. Comparison of radiother-
apy alone with radiotherapy plus hyperthermia in locally
advanced pelvic tumours: A prospective, randomised, mul-
ticentre trial.
Lancet
355: 119-1125.
3. Franckena, M., Stalpers, L.J., Koper, P.C., Wiggenraad, R.G.,
Hoogenraad, W.J., Van Dijk, J.D., Wárlám-Rodenhuis, C.C.,
Jobsen, J.J., Van Rhoon, G.C., Van der Zee, J. 2008. Long-
term improvement in treatment outcome after radiotherapy
and hyperthermia in locoregionally advanced cervix can-
cer: An update of the Dutch Deep Hyperthermia Trial.
Int J
Radiat Oncol
Biol Phys
70:1176-82.
4. Franckena, M., Lutgens, L.C., Koper, P.C., Kleynen, C.E., Van
der Steen-Banasik, E.M., Jobsen, J.J., Leer, J.W., Creutzberg,
C.L., Dielwart, M.F., Van Norden, Y., Canters, R.A.M., Van
Rhoon, G.C., Van der Zee, J. 2009. Radiotherapy and hyper-
thermia for treatment of primary locally advanced cervix
cancer: Results in 378 patients.
Int J Radiation Oncology Biol
Phys
73: 242-250.
14. Franckena, M., Fatehi, D., De Bruijne, M., Canters, R.A.M., Van
Norden, Y., Mens, J.W., Van Rhoon, G.C., Van der Zee, J. 2009
Hyperthermia dose-effect relationship in 420 patients with cer-
vical cancer treated with combined radiotherapy and hyperther-
mia. Accepted for publication
Eur J Cancer
45: 1969-1978.
