Locoregional hyperthermia in gynecology - Current status and perspectives

Locoregional hyperthermia includes local hyperthermia (heat treatment of superficial tumours, e.g., recurrent breast cancer on the thoracic wall), regional hyperthermia (treatment of larger volumes like the pelvis for intrapelvic tumours) and interstitial hyperthermia (heating electrodes are introduced within the tumour tissue). At present, the application of scientifically verified hyperthermia in Germany is carried out within the scope of controlled studies, or in cooperation with the Netherlands. Evidence for a beneficial effect comes from randomised studies in patients with recurrent breast cancer in previously irradiated areas (in combination with re-irradiation) and in patients with cervical carcinoma (in combination with primary radiotherapy). Preliminary results in patients with advanced vaginal carcinoma (FIGO stage II > 4 cm and FIGO stage III) suggest that also in these patients the results are better when radiotherapy is combined with hyperthermia. Further evidence of the efficacy of hyperthermia has to come from ongoing studies. One study compares radiotherapy plus hyperthermia with radiotherapy plus cisplatin, another study compares radiotherapy plus cisplatin with trimodality treatment, both in patients with cervical cancer FIGO stages IB-IV A. A phase II study investigates the results of magnetic fluid hyperthermia combined with interstitial radiotherapy in patients with inoperable local tumour recurrence. Further progress will come from experimental studies on tumour targeting approaches.

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