Hyperthermic applications and issues relating to the assessment of technical quality and its clinical verification

Hyperthermia is defined as a temperature elevation by several degrees (3-7 C) above the normal physiological level. In vitro and ill vivo experiments have shown that a cell kill response to hyperthermia in conjunction with radiotherapy exists (Harisiadis et al. (1975); Alfieri and Hahn, (1978); Dewey et al., (1977); Bhuyan, (1979)), Harisiadis et al, also report on the increased sensitivity to hyperthermia of tumour parts that are normally less sensitive to radiation alone. Tumour tissue differs from normal tissue in that it has a chaotic structure of the vascularisation. Due to this inferior vasculature structure, areas exist in the tumour with insufficient blood perfusion, which, in turn, causes local hypoxia and a low pH. Tumour cells in these hypoxic areas are relatively insensitive to radiation and because of the poor blood perfusion, a systemic chemotherapeutic approach for these areas has also less effect. One approach used to attack the cells in insufficiently perfused areas is hyperthermia in combination with radiotherapy or chemotherapy since hypoxic areas are relatively sensitive to hyperthermia. This makes hyperthermia an ideal complementary treatment modality to both radiotherapy and/or chemotherapy, taking into account that normal tissue in general tolerates a hyperthermic treatment of one hour with temperatures of up to 44 C without relevant clinical damage, i.e. 110 negative side-effects.

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