Interstitial, Endocavitary and Perfusional Hyperthermia

"Internal" hyperthermia is a type of thermotherapy by which heat is sup plied to tumor tissue in situ. There are three different techniques for pro viding internal hyperthermia: (1) interstitial hyperthermia using implanted needle probes, (2) intracavitary hyperthermia using probes introduced into natural body cavities, and (3) perfusional hyperthermia by means of ex tracorporal blood heating. Compared with external hyperthermia, internal hyperthermia has been preferentially accepted by oncologists because it can be more easily combined with other forms of treatment, e. g., interstitial thermotherapy with brachytherapy, or perfusional hyperthermia with che motherapy. Various types of equipment for interstitial and intracavitary thermotherapy have been developed and used quite extensively in clinical trials, generally in combination with radiation therapy. There are four different methods for producing interstitial or intracavitary hyperthermia, each related to different types of heating. Most studies have been performed using radiofrequency electrodes (resistive heating) or coaxial microwave antennas (radiative heating). Recently, however, "hot source" techniques that rely on thermal conduction and blood flow convection for heat transport have found clinical application. These techniques include ferromagnetic implants activated by hot water or by electrical means. In the near future, new methods for in terstitial or intraluminal heating based upon advanced ultrasonic and laser technologies will be developed.

Texte du rabat

This volume deals with "internal" hyperthermia - a type of thermotherapy in which heat is supplied to tumor tissue in situ - which involves three different techniques: (1) interstitial hyperthermia using implanted needle probes, (2) intracavitary hyperthermia using probes introduced into the natural cavities, and (3) perfusional hyperthermia through extracorporal blood heating. Compared with "external" hyperthermia, "internal" hyperthermia has been preferentially accepted by oncologists because it can be more easily combined with other forms of treatment, e. g., interstitial thermotherapy with brachytherapy, or perfusional hyperthermia with chemotherapy. Four different techniques for interstitial and intracavitary heating are presently being used in clinical trials, generally in combination with radiation therapy: radiofrequency electrodes, microwave antennas, hot water tubes, and inductively activated ferromagnetic implants. The principal advantages of interstitial and intracavitary thermotherapy are that: (1) the power deposition can be restricted to the tumor site, which minimizes toxic effects of various kind, and (2) thermal dosimetry can be performed more easily and with greater accuracy. This volume presents the technical and clinical state of the art in interstitial hyperthermia, and gives examples of applications of the other methods of internal hyperthermia in areas of major clinical interest in oncology, i. e., intracavitary hyperthermia in the treatment of cancers of the prostate, bladder, and esophagus and perfusional hyperthermia in the treatment of malignant melanoms.

Contenu
1 Interstitial Hyperthermia.- 1.1 Introduction.- 1.2 Physical and Technological Aspects of Interstitial Hyperthermia.- 1.3 Clinical Aspects of Interstitial Hyperthermia.- 1.4 Future Prospects.- 1.5 Conclusions.- References.- 2 Hyperthermia in Urology.- 2.1 Introduction.- 2.2 Hyperthermia of the Urinary Bladder.- 2.3 Hyperthermia of the Prostate.- 2.4 Conclusions.- References.- 3 Experimental and Clinical Studies of Hyperthermia for Carcinoma of the Esophagus.- 3.1 Introduction.- 3.2 Biological Basis for Prescription of the Combination of Hyperthermia, Chemotherapy, and Irradiation.- 3.3 Heat Delivery for Carcinoma of the Esophagus.- 3.4 Clinical Investigations on the Combination of Hyperthermia, Chemotherapy, and Irradiation for Carcinoma of the Esophagus.- 3.5 Prospects of Hyperthermia.- References.- 4 Combined Hyperthermia and Chemotherapy for Malignant Melanoma of the Limbs.- 4.1 Concepts and Problems in the Treatment of Malignant Melanomas.- 4.2 Biological Basis of Combined Hyperthermia and Chemotherapy.- 4.3 Treatment Techniques and Protocols.- 4.4 Clinical Trials and Results: The Strasbourg Experience.- 4.5 Discussion and Comments.- 4.6 Conclusion.- References.