Hyperthermia in OncologyFélix Navarro GuiradoMedical PhysicistEngineer

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Content

1) What is it? 2) What for?3) Clinical evidence?4) How?5) Around the world?

Hyperthermia

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Hyperthermia

1) Heat up tumors up to 41 ºC – 45 ºC (106 ºF – 113 ºF)

2) Non ablative3) Boosting therapy for CT / RT

What is it?

What is it NOT?Stand alone therapy

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1) What is it? 2) What for?3) Clinical evidence?4) How?5) Around the world?

Hyperthermia

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Hyperthermia What for?RT/CT target: DNA DAMAGE

Int J Hypert 2012, 28(6):509-517Who does perform DNA repair process?

How?

Hyperthermia What for?

Hyperthermia What for?

Mechanism of radiosensitization by hyperthermia as derived from studies with DNA repair defective mutant cell lines. Kampinga HH et al.,INT. J. HYPERTHERMIA VOL. 20, NO.2(MARCH 2004), pp. 131–139

Effects of hyperthermia on DNA repair pathways: one treatment to inhibit them all. Oei AL et al.,Radiat Oncol. 2015 Aug 7;10:165.

Radiosensitization of heat resistant human tumour cells by 1 hour at 41.1 degrees C and its effect on DNA repair. Xu M. et al.Int J Hyperthermia. 2002 Sep-Oct;18(5):385-403

Hyperthermia What for?

Dynamics of Cell Membrane Permeability Changes at Supraphysiological Temperatures.J. C. Bischof,et al. Biophys J. 1995(68): 2608-2614

Membrane Effects of Ionizing Radiation and Hyperthermia. Int J Rad Biol on Physics, Chemistry & Med. 1995 49(5):743-770

Int J Hyperthermia 2013. 29(6):528-538

Hyperthermia What for?Hyperthermia effects:

1. DNA repair inhibition2. Drug uptake improvement3. Abscopal effect enhancement (HSP70Antigen collector)

4. Hypoxic volume reduction5. Cell cycle redistribution

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Content

1) What is it? 2) What for?3) Clinical evidence?4) How?5) Around the world?

Hyperthermia

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Hyperthermia

2015 Impact Factor: 3.361 8 Issues/year since 1985Ranking: 37/125 Radiology 83/213 Oncology

Hyperthermia

Adding hyperthermia to the standard treatment has been proved to improve respone ratio: (Level 1)

- Advanced Cervix(van der Zee 2000)- Breast recurrency (Vernon 1996, Jones 2005)- Soft tissue sarcoma(Issels 2008)- H&N recurrency (Valdagni 1994)- Advanced bladder cancer (Colombo 2003)- Anus (Kouloulias 2005)- Cell tumours (Wessalowski 1998)

Indications supported by

American Cancer Society

Hyperthermia

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1) What is it? 2) What for?3) Clinical evidence?4) How?5) Around the world?

Hyperthermia

Hyperthermia

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Content

1) What is it? 2) What for?3) Clinical evidence?4) How?5) Around the world?

Hyperthermia

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Thank-you