Since the first observations of Busch in 1866, the possible use of heat as a therapeutic agent in the cure of cancer has been repeatedly subject to bursts of interest, almost invariably followed by periods of neglect and skepticism. In 1963-1964, this problem was again attacked by us both from the biochemical and from the clinical points of view. The first results of this joint effort were positive beyond expectation, and generated a new revial of studies aimed at the identification of the nature of the bio­ chemical lesion as well as at the optimization of technique and of the therapeutic schedules connected with clinical use. Although the number of mammalian tumors which have been proved to be heat-sensitive is now relatively large, and although in some cases a correlation has been demonstrated between tumorigenicity and heat-sensitivity of in vitro cultured cell lines, the question of a direct and constant relationship between neoplastic character and higher sensitivity to hyperthermic exposure is still open to continuing investigation and reappraisal. Several studies deal in fact with the determination of the conditions under which, in vitro and or in vivo, different tumors are efficiently damaged by elevated temperatures.

Inhalt

1. Introduction.- 2. Biochemical Aspects of Heat Sensitivity of Tumour Cells.- 1. Introduction.- 2. Selectivity of the Lethal Effect of Supranormal Temperatures on Tumour Cells.- 3. Nature of the Lesions Caused by Supranormal Temperatures in Mammalian Cells.- 4. Thermal Sensitivity and the Cell Cycle.- 5. Possible Molecular Mechanism(s) of the Heat-Induced Cell Damage.- A. Nucleic Acide and/or Proteins.- B. Membrane Systems.- 3. Actions of Hyperthermia on Tumour Cells Cultured in vitro.- 4. The Effects of Hyperthermia in Animal Tumour Systems.- 1. Introduction.- 2. Animal Tumour Models.- 3. Current Approches.- A. In vivo Methodology.- B. In vitro Methodology.- 4. The Effects of Heat on Animal Tumours.- A.Biochemical Changes.- B. Histological Changes.- C.Local Hyperthermia vs Total Body Hyperthermia.- 5. Hazards and Potentiators of Hyperthermia in the Treatment of Cancer.- A. Hazards of Hyperthermia.- B. Potentiators of Hyperthermia.- 6. Discussion.- A. Relationship Between Primary Tumours and Its Metastases and Host-Tumour Relationship.- B. Bacteria, Hyperpyrexia and the Immune System.- 7. Implications of Current Results for Human Therapy.- A. In vitro Sensitivity of Human Tumours to Hyperthermia (42 °C).- B. Schedule for Heating Human Tumours in vivo.- C. Value of Animal Test Systems.- 8. Summary and Perspectives.- 5. Hyperthermic Treatment of Tumours: Experimental and Clinical Applications.- 1. Introduction.- 2. Experimental Studies.- A. Whole-Body Hyperthermia.- B. Local Hyperthermia by Perfusion on Dogs.- C. Experimental Models.- 3. Clinical Application.- A. Whole-Body Hyperthermia.- B. Local Heating.- 4. Technique.- 5. Case Report.- 6. Discussion.- 6. Whole-Body Hyperthermia. A Systemic Treatment for Disseminated Cancer.- 1. Methods of Inducing Hyperthermia.- 2. Anaesthesia During Hyperthermia.- 3. Method.- 4. Haemodynamic Response.- 5. Biochemical and Haemotological Changes.- 6. Clinical Results.- 7. Assessment of Response.- 8. Hyperthermia Alone.- 9. Case Reports.- 10. Hyperthermia in Combination with Cytotoxic Drugs.- 11. Case Reports.- 12. Hyperthermia Combined with Local Radiotherapy.- 13. Complications.- 14. Fractionation of Hyperthermia.- 15. Future Management.- 16. Summary.- 7. Hyperthermic Perfusion of Extremities for Melanoma and soft Tissue Sarcomas.- 1. Introduction.- 2. Melanomas.- 3. Discussion.- 4. Conclusions.- 5. Sarcomas.- 6. Results.- 7. Discussion.- 8. Conclusions.