Practical limitations of interstitial thermometry during deep hyperthermia

Purpose: Intratumor thermometry during hyperthermia treatment is considered important for several reasons. The morbidity that we experienced from interstitially placed catheters in deep-seated tumors gave reason to weigh the advantages and disadvantages against each other. Methods and Materials: The available thermometry in 215 patients treated with hyperthermia for deep-seated tumors was analyzed with the aim to evaluate practically feasible intratumor measurements. The influence of intratumor measurements on the treatment procedure was assessed. Results: Total 120 catheters were placed interstitially in 78 patients. Over the years, the percentage of patients with interstitial thermometry decreased considerably. Forty-nine catheters could remain in place during the whole hyperthermia treatment series. The remaining catheters had to be removed for more or less severe complications, including one fatal event. In fact, the interstitial catheters caused the most severe treatment-related morbidity. During 188 of the total 859 treatments, at least one interstitial catheter was available for thermometry. Per treatment with catheter(s) in situ, the average number of intratumor measurement sites was 6.9. The value of interstitial thermometry for power steering during treatment, to both optimize intratumor temperature distribution and prevent toxicity, appeared limited. The mean volume of the tumors with interstitial thermometry was 314 cm3, SD 325. In relation to the large tumor volumes, the thermal dose parameters calculated from the available data is considered to be of limited value. Conclusion: In view of the possible severe complications and the limited clinical value of the information achieved by interstitially placed thermometry catheters, interstitial thermometry was not found to routinely benefit the individual patient.

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