• Title/Summary/Keyword: Chemotherapy and Hyperthermia

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Long-term Efficacy of Microwave Hyperthermia Combined with Chemoradiotherapy in Treatment of Nasopharyngeal Carcinoma with Cervical Lymph Node Metastases

  • Kang, Min;Liu, Wen-Qi;Qin, Yu-Tao;Wei, Zhu-Xin;Wang, Ren-Sheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7395-7400
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    • 2013
  • Objective: The long-term efficacy of microwave hyperthermia combined with chemoradiotherapy in treating nasopharyngeal carcinoma (NPC) with metastatic foci in cervical lymph nodes was evaluated. Methods: A total of 154 cases of N2 or N3 stage NPC were randomized into two groups: hyperthermia group (76 cases) and control group (78 cases). Both received cisplatin chemotherapy and radiotherapy. In addition, the hyperthermia group further received microwave hyperthermia to the metastatic cervical nodes with different patterns (before or after radiotherapy), heating temperatures (T90< $43^{\circ}C$ and $T90{\geq}43^{\circ}C$) and hyperthermia episodes (< 4 times, 4-10 times and > 10 times). Results: The 3-month and 5-year complete response (CR) rates of cervical lymph nodes in the hyperthermia group were significantly higher than those in the control group. The 5-year disease-free survival (DFS) rate and the 3-year / 5-year overall survival rate in the hyperthermia group were also significantly higher. There was no significant difference in 5-year metastatic rates. In the hyperthermia group, the 3-month and 5-year CR rates of T90< $43^{\circ}C$ treatment were significantly lower than with $T90{\geq}43^{\circ}C$ treatment. The CR rate was highest when the hyperthermia was performed 4-10 times. There were no significant differences in 3-month and 5-year CR rates between hyperthermia before or after radiotherapy treatment. Conclusion: Microwave hyperthermia combined with chemoradiotherapy can increase local control, DFS and 3, 5-year overall survival rates of patients with N2 ~ N3 stage NPC. The heating temperature should be over $43^{\circ}C$ with hyperthermia repeated 4-10 times.

Effect of Increased Intracellular pH by HMA on the Cytotoxicity of Combined Treatment of Hyperthermia and Chemotherapy (HMA의 세포내 산도증가가 온열과 항암화학 치료의 세포독성에 미치는 효과)

  • Hur, Won-Joo;Song, Chang-Won
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.121-128
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    • 1995
  • Purpose: The enhanced cytotoxic effect of combined treatment of hyper-thermia and chemotherapy by increasing intracellular acidity with HMA was investigated. Materials and Methods: FSall tumor cells were injected on the hindlegs of female $C_3H$ mice. When the tumor volume reached about 200mm3, experiments were performed on the groups classified as follows: Group I :Control, Group II : Melphalan alone (2.5mg/kg, 5mg/kg, 10mg/kg, 15mg/kg), Group III : Heat alone $(42.5^{\cdot}C$ for 1 hour) Group IV : Melphalan + Heat $(42.5^{\cdot}C$ for 1 hour), Group V : HMA(10mg/kg) + Melphalan(5.0mg/kg) + Heat$(42.5^{\cdot}C$ for 1hour). Each group included 8-12 mice on each experiment HMA (3-amino-6-chloro-5-(1-homopiperidyl )-N-(diaminomethylene) -c-pyrazinecarboxamide), an analog of amiloride which increases intracellular pH(pHi) was dissolved in dimethyl sulfoxide (DMS) and injected into the tumor-bearing mice through the tail vein. 10mg/kg of HMA and each dose of melphalan were injected into peritoneum of the tumor-bearing mice 30 minutes before heating. Tumor growth delay was calculated when the tumor volme reached at $1500mm^3$ Excision assay was performed on each group and repeated 2-4 times. Results : Tumor growth delay of each experimental groups at $1500mm^3$ were 9, 10, 13 and 19 days respectively. In vivo-in vitro excision assay using FSall tumor cells, the cytotoxicity of each experimental groups was $1.2{\times}10^7,\;1{\times}10^7,\;6{\times}10^6,\;1.7{\times}10^6\;and\;1{\times}10^5$ clonogenic cells/gm respectively When HMA was added to the combined treatment of heat and .chemotherapy, the tumor growth was delayed more than combined treatment without HMA i.e., 6 days tumor growth delay at $1500mm^3$ of tumor volume. Conclusion: The combined effect of cytotoxicity by heat and chemotherapy can be much more enhanced by HMA.

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Hyperthermia for Head and Neck Cancer - Preliminary Result of Hyperthermia Using 8 MHz Radiofrequency in Treatment of Advanced and Recurrent Head and Neck Cancer- (두경부암의 온열요법 -국소적으로 진행 혹은 재발된 두경부암 치료에 있어서 8MHz 라디오파를 이용한 온열요법의 중간보고 -)

  • Park K.R.;Lee C.G.;Kim S.K.;Cho K.H.;Suh C.O.;Kim G.E.;Loh J.K.;Kim B.S.;Hong W.P.;Park C.S.
    • Korean Journal of Head & Neck Oncology
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    • v.3 no.1
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    • pp.107-114
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    • 1987
  • Clinical application of hyperthermia using 8 MHz radiofrequency(capacitive type THERMOTRON RF-8) in cancer treatment was begun at Yonsei Cancer Center in 1985. From April 1985 to April 1986, 23 patients with loco-regionally advanced and persistent or recurrent carcinomas of the head and neck were treated with hyperthermia at the Department of Radiation Oncology, Yonsei University College of Medicine. Radiation therapy and/or chemotherapy were combined with hyperthermia to improve the tumor response. The response rate of 23 patients was 52%, 4 had complete response, and 7 had partial response. The factors affecting the tumor response were dose of irradiation(P=0.009). Complications related to treatment were found in 8 patients and all of them were self-limited. The result of this study indicates that localized hyperthermia as a combined modality has a significant role in palliation of advanced and recurrent head and neck cancer.

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Effects of Regional Hyperthermia with Moderate Temperature on Cancer Treatment (국부 중등도 온열요법의 암치료 효과)

  • Kang, Chi-Dug;Kim, Sun-Hee
    • Journal of Life Science
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    • v.26 no.9
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    • pp.1088-1096
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    • 2016
  • Despite that moderate hyperthermia can exert various antitumor activities such as direct cytotoxic effects on tumor cells, effects on tumor vasculatures and immunological effects, hyperthermia has been usually combined with radiotherapy or chemotherapy due to its limited efficacy in cancer treatment, showing some positive clinical benefits with generally well-tolerated side effects. Since heat shock responses itself can interfere with the anti-tumor effects of hyperthermia, not all of these studies might have demonstrated positive clinical outcomes in cancer patients. Therefore, the negative anti-tumor effect of hyperthermia should be reduced to enhance the effectiveness of hyperthermia. Although the responses to heat stress of tumor tissues containing vessels, immune cells, connective tissues as well as cancer cells, are very complicated, it is needed to study in the near future if some clinically available drugs, which can modulate heat stress responses, can improve the efficacy of hyperthermia in patients with cancer. In this review, the effect of clinical hyperthermia centered on non-invasive external hyperthermia using radiofrequency at moderate temperature will be discussed, since it is the state-of-the-art technology in the current clinical practice of hyperthermia, and a moderate operational temperature is used to increase the therapeutic effectiveness of conventional therapy without additional toxicity to normal tissues.

Therapeutic Effect of Combined Radiotherapy and Hyperthermia in Primary Hepatocellular Carcinoma (원발성 간암의 방사선치료및 온열요법의 병용치료 효과)

  • Kang Ki Mun;Choi Ihl Bohng;Kay Chul Seung;Choi Byung Ok;Chung Su Mi;Kim In Ah;Han Sung Tae;Sun Hee Sik;Chung Kyu Won;Shinn Keyong Sub
    • Radiation Oncology Journal
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    • v.12 no.2
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    • pp.191-199
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    • 1994
  • Purpose : This study was undertaken to show the clinical results of combined radiotherapy and hyperthermia in primary hepatoma Materials and Methods : Between December 1989 and March 1993, 50 patients with hepatomas were treated by combined radiotherapy and hyperthermia. Among them, we analyzed retrospectively 33 patients who received the complete course of treatment. The ages of the patients ranged from 36 to 75(mean age: 55.5 years). Twenty-six patients ($78.8\%$) were men, and 7 ($21.2\%$ were women. According to Child's classification, nine patients ($27.3{\%}$) were A group, 9 ($27.3\%$) were B group, 15 ($45.4\%$) were C group. Radiation therapy was done by a 6 MV and 15 MV linear accelerator. Patients were treated with daily fractions of 150-180 cCy to doses of 2550 cGy -4950 cGy (median : 3000 cGy). Local hyperthermia was done by 8 MHZ RF capacitive heating device (Cancermia. Green Cross Co., Korea), 50-60 min/session, 1-2 sessions/wk, and 8.5 sessions (median number)/patient. We analyzed the prognostic factors including age, sex, tumor type, Child's classification, $\alpha$-fetoprotein, liver cirrhosis, ascites, portal vein invasion, esophageal varix, number of hyperthermia, chemotherapy, total bilirubin level, Karnofsky perfomance status. Results : The overall 1-year survival was $24.2\%$, with a mean survival of 10months. Of 33 patients, tumor regression (PR+MR) was seen in $30.4\%$, no response was seen in $52.2\%,\;17.4\%$ patient was progressed. In patients who had tumor regression, the overall 1-year survival was $42.1\%$ with a mean survival of 14 months. Factors influencing the survival were sex (p=0.05), tumor type (p=0.0248), Child's classification (p=0.0001), liver cirrhosis (p=0.0108), ascites (p=0.0009), and Karnofsky perfomance status (p=0.0028). Complications developed in 28 patients, including 18 hot pain,5 fat necrosis, 3 transient fever, 2 nausea and vomiting. Conclusion : In this study, the results suggests that combined radiotherauy and hyperthermia may improve the survival rate of hepatoma.

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Comparison Different Methods of Intraoperative and Intraperitoneal Chemotherapy for Patients with Gastric Cancer: A Meta-analysis

  • Huang, Jin-Yu;Xu, Ying-Ying;Sun, Zhe;Zhu, Zhi;Song, Yong-Xi;Guo, Peng-Tao;You, Yi;Xu, Hui-Mian
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4379-4385
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    • 2012
  • Purpose: To investigate the efficacy and safety of intraperitoneal chemotherapy (IPC) for patients with gastric cancer and to compare effects between different regimens of IPC. Method: Randomized controlled trials comparing the effects of surgery plus intraperitoneal chemotherapy with surgery alone or comparing the efficacy between different regimens of intraperitoneal chemotherapy were searched for in Medline, Embase, Pubmed, the Cochrane Library and the Chinese BioMedical Disc and so on by two independent reviewers. After quality assessment and data extraction, data were pooled for meta-analysis using RevMan5.16 software. Tests of interaction were used to test for differences of effects among subgroups grouped according to different IPC regimens. Results: Fifteen RCTs with a total of 1713 patients with gastric cancer were included for quality assessment and data extraction. Ten studies were judged to be of fair quality and entered into meta-analysis. Hyperthermic intraoperative intraperitoneal chemotherapy (HR=0.60, P<0.01), hyperthermic intraoperative intraperitoneal chemotherapy plus postoperative intraperitoneal chemotherapy (HR=0.47, P<0.01) and normothermic intraoperative intraperitoneal chemotherapy (HR=0.70, P=0.01) were associated with a significant improvement in overall survival. Tests of interaction showed that hyperthermia and additional postoperative intraperitoneal chemotherapy did not impact on its effect. Further analysis revealed that intraperitoneal chemotherapy remarkably decrease the rate of postoperative hepatic metastasis by 73% (OR=0.27, 95% CI=0.12 to 0.67, P<0.01). However, intraperitoneal chemotherapy increased risks of marrow depression (OR=5.74, P<0.01), fever (OR=3.67, P=0.02) and intra-abdominal abscess (OR=3.57, P<0.01). Conclusion: The present meta-analysis demonstrates that hyperthermic intraoperative intraperitoneal chemotherapy and normothermic intraoperative intraperitoneal chemotherapy should be recommended to treat patients with gastric cancer because of improvement in overall survival. However, it is noteworthy that intraperitoneal chemotherapy can increase the risks of marrow depression, intra-abdominal abscesses, and fever.

Intrapleural Perfusion Hyperthermic-Chemotherapy for Pleural Seeding of Lung Cancer (폐암의 흉막파종에 대한 흉막강내 온열-항암제 관류요법)

  • Jheon, Sang-Hoon;Kang, Hyung-Seok;Lee, Sub;Kwon, Oh-Choon;Ahn, Wook-Su;Lee, Eung-Bae
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.608-610
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    • 2002
  • Lung cancer with pleural seeding has poor prognosis and is generally treated by intravenous anticancer chemotherapy only. We performed intrapleural perfusion hyperthermic-chemotherapy in two lung cancer patients with pleural seeding. Herein, we report our outcome with literature review.

Fabrication of Microwave Applicator for Hyperthermia and Thermal Distribution in Tissues (종양의 온열치료를 위한 마이크로잔 조사장치의 제작과 응용)

  • Chu S. S.;Lee J. T.;Kim G. E.
    • Radiation Oncology Journal
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    • v.2 no.1
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    • pp.11-20
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    • 1984
  • The renewed interest in the use of hyperthermia in cancer therapy is bases on radiobiological and clinical evidence indicated that there may be a significant therapeutic advantage with the use of heat alone or combined with radiation or chemotherapy, There are many methods for generating heat for localized tumor as like radiofrequency, microwave, electromagnetic induction and ultrasound. But it is very difficult to be even thermal dose distribution and stable output of power and then the detection of temperature in tumor is difficult to be precise with thermocouples and semiconductor sensors. We designed the microwave heating generator, dipole antenna applicators and autometic temperature controlled thermocouples for localized hyperthermia on skin and in cavities. 1. The microwave generator with 120 W, 2,450MHz magnetron could be heating up to $40^{\circ}C\~50^{\circ}C\;for\;1\~2$ hours in living tissues. 2. The thermal dose distribution in tissue with microwave was described $42^{\circ}C\~44^{\circ}C$ with in 3 cm depth and $2\~6cm$ diameter area. 3. Skin surface heating applicator with spiral 3 times wave length antenna radiated high Power of microwave. 4, Intracavitary heating applicator with dipole antenna with autometic control temperature sensor kept up continuously constant temperature in tissue. 5. For constant thermal distribution, applied two steps power with 10W microwave after $17\~20W$ during first 10 minutes. 6. The cooling rate by blood flew in living tissue was rised as $10\%$ then meats.

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Successful Outcome of an Elderly Patient with Small Cell Lung Cancer with only Alternative Treatments: A Case Report

  • Lee, Sanghun;Joo, Jeonghyun;Chon, Songha
    • The Journal of Korean Medicine
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    • v.39 no.4
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    • pp.171-176
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    • 2018
  • Background: Small cell lung cancer (SCLC) tends to grow more rapidly and spread much faster than non-small cell lung cancer (NSCLC). A concurrent combination of chemotherapy and thoracic radiotherapy is suggested as the standard conventional treatment, but it is more challenging for elderly patients having pulmonary and cardiovascular comorbidities. Case presentation: Here we present a case of an 80-year-old male, current smoker diagnosed with SCLC in limited stage T3N0M0 (36mm right upper lobe, satellite nodule) in Dec, 2015. The standard concurrent chemoradiotherapy was not available for his comorbidities, which included chronic obstructive pulmonary disease (COPD) and angina pectoris. Furthermore, he and his family refused the recommended chemotherapy or radiotherapy exclusively. Alternatively, he received various non-conventional treatments including local radiofrequency hyperthermia, mistletoe, and Traditional Korean medicine including acupuncture, moxibustion and herbs since Jan. 2016. Despite the progression in primary tumor size, there have been no other distant relapse so far, and the patient has been in stable condition ever since. Conclusion: We suggest that a combination of various alternative treatments could be a candidate for elderly patients intolerable to conventional cytotoxic treatments.

Preparation and characterization of Poly(2-methacryloyloxyethyl phosphorylcholine/fluorescein O-methacrylate)-coated iron oxide nanoparticles (Poly(2-methacryloyloxyethyl phosphorylcholine/fluorescein O-methacrylate)가 도입된 산화철 나노 입자의 제조 및 발열 특성 연구)

  • Ryu, Sunggon;Cheong, In Woo
    • Journal of Adhesion and Interface
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    • v.19 no.3
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    • pp.106-112
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    • 2018
  • Recently, the hyperthermia treatment of malignant tissues has gained great attention as a biocompatible and benign method that facilitates successful cancer therapy compared to radiation and chemotherapy. In this study, superparamagnetic ($Fe_3O_4$) iron oxide nanoparticles (IONP) coated with biocompatible polymer (IONP@P(MPC/FOM)) for the purpose of hyperthermia treatment were prepared and related characterization were performed. IONPs with having 15 nm diameter were first prepared by coprecipitation and followed by surface modification with 4-cyanopentanoic acid dithiobenzoate (CTP) for reversible addition-fragmentation chain transfer (RAFT) copolymerization by using 2-methacryloyloxyethyl phosphorylcholine (MPC) and fluorescein O-methacrylate (FOM) to form corona layer of P(MPC/FOM) on the surface of the IONP. Transmission electron microscopy (TEM) and dynamic light scattering (DLS) confirmed the morphology and hydrodynamic size of the IONP@P(MPC/FOM) and thermogravimetric analysis (TGA) confirmed the formation of P(MPC/FOM) corona layer, respectively. Exposing IONP dispersion to alternating magnetic field suggests that the IONP@P(MPC/FOM) aqueous dispersion with 0.2 wt.% can be used for hyperthermia treatment.