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Tumour therapy depends essentially on being able to destroy the clonogenic activity of tumour cells while keeping the damage to the normal tissue low. Clinical experience shows that tumour response varies greatly even if tumours with the same localisation, clinical, and histopathological staging are compared. Some tumours appear to be resistant to conventional radiotherapy (X-rays, y-rays or fast electrons) or chemotherapy. In these cases new therapy modalities are necessary. Combined therapy modalities seem to have advan tages for some resistant tumours; one possibility of such a treatment is to combine radiotherapy or chemotherapy with hyperthermia. This means that the local tumour, the tumour region or even the whole body of the patient has to be heated to temperatures between 40° to 45° C (in case of whole body hyperthermia to 42° C maximal) for a certain time (usually 30-60 min are adequate). Hyperthermia has a long tradition in medicine as a treatment modality for various diseases. Inscriptions of the old Egyptians and texts of the Greeks have pointed out its importance. Usually whole body hyperthermia has been used by the induction of fever. Local hyperthermia began around 1900 when Westermark treated unre sectable cervix carcinomas with hot water in a metallic coil. By the beginning of this century an increase of radiation effects was hy pothesised with hypothermia and later observed. However, only in the 1960s and 1970s were systematic investigations started which showed radiosensitisation and chemosensitisation by hyperthermia in cells and tissues including tumours.
Hyperthermia has been found to be of great benefit in combination with radiation therapy or chemotherapy in the management of patients with difficult and com plicated tumor problems. It has been demonstrated to increase the efficacy, of ionising radiation when used locally but also has been of help in combination with systemic chemotherapy where hyperthermia is carried out to the total body. Problems remain with regard to maximizing the effects of hyperthermia as in fluenced by blood flow, heat loss, etc. The present volume defines the current knowledge relative to hyperthermia with radiation therapy and/or chemotherapy, giving a comprehensive overview of its use in cancer management. Philadelphia/Hamburg, June 1995 L.W. BRADY H.-P. HEILMANN Preface In an attempt to overcome tumor resistance, hypoxia, or unfavorable tumor condi tions, oncological research has come to focus on gene therapy, immunotherapy, new cytotoxic agents, and increasingly sophisticated radiotherapy. Radiation research has been directed towards heavy particle therapy and modification of the radiation response by either protecting or sensitizing agents. Improved dose localization using rotational or conformal strategies has also been implemented. Recently, changes in radiation fractionation schedules have shown promise of better results. Hyperthermia in cancer therapy can be viewed similarly as another means to increase the sensitivity of tumors to radio- and chemotherapy.
This work describes the ways in which the techniques of hyperthermia have been used in a project in Japanese oncology clinics since 1984. The physical, biological and clinical aspects of hyperthermic oncology are detailed.
This book presents all effective and safe techniques in interstitial hyperthermia and gives examples of applications in areas of clinical interest. Interstitial hyperthermia has been preferentially accepted by oncologists because it can be easily combined with other forms of treatment. One of the principal advantages is the threedimensionally restricted heat deposition to the tumor site. The contributions in this book are written by experts in the fields of biology, physics, and clinical implementation. The technical and clinical state of the art as well as quality assurance in interstitial hyperthermia is presented and practical information for the oncologists working in this field is given.
Emerging Electromagnetic Medicine presents the latest research findings in the field of electromagnetic radiation. The book discusses the research of current active researchers in terms of synthesizing and sharing their ideas on the use of electromagnetic fields in diagnostic and therapeutic medicine, now and in the future, including the benefits and risks involved. The book consists of three parts prefaced by a brief historic perspective. Section I describes the theoretical concerns and actual mechanisms involved; Section II covers current preclinical studies, performed in vivo and in vitro, concerning the biological action of the electromagnetic radiation; and Section III reports on actual clinical applications of electromagnetic therapy and also the current machinery used to do so.
While the establishment of hyperthermia as a routine therapy awaits the results of ongoing controlled clinical trials, the advancement in biological sciences, physics and engineering, clinical physics and dosimetry, as well as clinical implementation continues to make advances. A first attempt to document these advances was made by Dr. Gilbert H. Nussbaum in the Medical Physics Monograph No. 8 of the American Association of Physicists in Medicine, published by the American Institute of Physics in 1982. This monograph is an extension of the above work. The material is divided into six catagories: Hyperthermia Biology, Physics and Engineering, Clinical Physics, Dosimetry and Modeling, Analysis of Clinical Results, and Quality Assurance. There are numerous methods of inducing hyperthermia and there are also equally numerous clinical strategies as expected in an experimental modality. A conscious effort has been made to document the basic information and thus provide an objective learning tool. The material contained herein will be of interest to biologists, physicists, engineers, and physicians who are actively involved in the field of hyperthermia, as well as to those who are anxious to learn about this new field. Some sections provide extremely practical information needed in the routine delivery of treatments and, therefore, will be of benefit to nurses and technologists. We also believe that this material provides insight and guidance for future research.