In the 1960s a firm rationale was developed for using raised temperatures to treat malignant disease and there has been a continuous expansion of the field ever since. However, a major limitation exists in our ability to heat human tumours, especially those sited deep in the body, with a reasonable degree of temperature uniformity. This problem has resulted in engineers and physicists collaborating closely with biologists and clinicians towards the common goal of developing and testing the clinical potential of this exciting treatment modality. The aim of the physicist and engineer is to develop acceptible methods of heating tumQur masses in as many sites as possible to therapeutic temperatures avoiding excessive heating of normal structures and, at the same time, obtaining the temperature distribution throughout the heated volume. The problem is magnified by both the theoretical and technical limitations of heating methods and devices. Moreover, the modelling of external deposition of energy in tissue and knowledge of tissue perfusion are ill-defined. To this must be added the conceptual difficulty of defining a thermal dose. The NATO course was designed to provide a basis for the integration of physics and technology relevant to the development of hyperthermia. There were 48 lectures covering the theoretical and practical aspects of system design and assessment, including, as far as possible, all the techniques of current interest and importance in the field.

Inhalt

Section I - Lecturers' Chapters.- 1. Problems in Cancer Treatment.- 2. Biological Aspects of Hyperthermia.- 3. Biological Basis for Rational Design of Clinical Treatment with Combined Hyperthermia and Radiation.- 4. Hyperthermia Heating Technology and Devices.- 5. Electromagnetic Field Generation and Propagation.- 6. Calculation of Electromagnetic Power Deposition.- 7. Electromagnetic Power Deposition: Inhomogeneous Media, Applicators and Phased Arrays.- 8. Electromagnetic Applicators for Non-invasive Local Hyperthermia.- 9. Interstitial Techniques for Hyperthermia.- 10. Electromagnetic Regional Heating.- 11. Radiofrequency Power Sources for Hyperthermia.- 12. Phantoms for Electromagnetic Heating Studies.- 13. Biological Effects of Electromagnetic Waves.- 14. Principles of Ultrasound Used for Hyperthermia.- 15. Ultrasonic Heating Techniques.- 16. Ultrasound Phantoms/Animals Experiments.- 17. Laboratory Techniques for Heating Experimental Animals.- 18. Whole Body Hyperthermia as a Treatment Modality.- 19. Blood Flow.- 20. Tumour Microcirculation.- 21. Effects of Hyperthermia on Tumour Microcirculation.- 22. Thermometry.- 23. Non-invasive Methods of Temperature Measurement.- 24. Heat Transfer in Tissues.- 25. Thermal Models/Temperature Distributions.- 26. Treatment Planning and Evaluation.- 27. The Combination of Heat and Radiation in Cancer Treatment.- 28. The Role of Hyperthermic Perfusion in Treating Limb Tumors: Our Experience at Regina Elena Cancer Institute.- 29. The Design of Clinical Trials in Hyperthermic Oncology.- Section II - Discussion Reports.- 1. Principles of Cancer Therapy and Clinical Trials.- 2. Thermobiology and Physiology.- 3. Calculation of Electromagnetic Power Deposition.- 4. EM Hazards; Protection of Patients and Operators; EM Field Dosimetry.- 5. Safety and Quality Control Panel.- 6. Heating Tumours in Small Animals.- 7. New Approaches to Hyperthermia Systems.- 8. Ultrasound Hyperthermia.- 9. Temperature Measurements and Dosimetry.- 10. From the Hyperthermia Laboratory to the Treatment Room.- 11. Which Hyperthermia System? A Survey of Methods, Equipment and Problems.