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This third volume in the series "Hyperthermia and Oncology" provides insight in and updated information on various aspects of interstitial hyperthermia. It aims to serve as a guide for clinicians who are either already working in the field or who wish to implement this treatment.
An authoritative guide to theory and applications of heat transfer in humans Theory and Applications of Heat Transfer in Humans 2V Set offers a reference to the field of heating and cooling of tissue, and associated damage. The author—a noted expert in the field—presents, in this book, the fundamental physics and physiology related to the field, along with some of the recent applications, all in one place, in such a way as to enable and enrich both beginner and advanced readers. The book provides a basic framework that can be used to obtain ‘decent’ estimates of tissue temperatures for various applications involving tissue heating and/or cooling, and also presents ways to further develop more complex methods, if needed, to obtain more accurate results. The book is arranged in three sections: The first section, named ‘Physics’, presents fundamental mathematical frameworks that can be used as is or combined together forming more complex tools to determine tissue temperatures; the second section, named ‘Physiology’, presents ideas and data that provide the basis for the physiological assumptions needed to develop successful mathematical tools; and finally, the third section, named ‘Applications’, presents examples of how the marriage of the first two sections are used to solve problems of today and tomorrow. This important text is the vital resource that: Offers a reference book in the field of heating and cooling of tissue, and associated damage. Provides a comprehensive theoretical and experimental basis with biomedical applications Shows how to develop and implement both, simple and complex mathematical models to predict tissue temperatures Includes simple examples and results so readers can use those results directly or adapt them for their applications Designed for students, engineers, and other professionals, a comprehensive text to the field of heating and cooling of tissue that includes proven theories with applications. The author reveals how to develop simple and complex mathematical models, to predict tissue heating and/or cooling, and associated damage.
Following an introductory overview, Hyperthermia In Cancer Treatment: A Primer comprehensively describes the biological reasons for associating hyperthermia with radiation and chemotherapy and the biological and clinical effects of hyperthermia on cancerous and normal tissues. The volume’s 20 chapters are arranged in three principal parts: physical and methodological studies, biologic principles, and clinical studies.
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.
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.
In the 1960s a firm rationale was developed for using raised temperatures to treat malignant disease and there has been a continuous expansion of the field ever since. However, a major limitation exists in our ability to heat human tumours, especially those sited deep in the body, with a reasonable degree of temperature uniformity. This problem has resulted in engineers and physicists collaborating closely with biologists and clinicians towards the common goal of developing and testing the clinical potential of this exciting treatment modality. The aim of the physicist and engineer is to develop acceptible methods of heating tumQur masses in as many sites as possible to therapeutic temperatures avoiding excessive heating of normal structures and, at the same time, obtaining the temperature distribution throughout the heated volume. The problem is magnified by both the theoretical and technical limitations of heating methods and devices. Moreover, the modelling of external deposition of energy in tissue and knowledge of tissue perfusion are ill-defined. To this must be added the conceptual difficulty of defining a thermal dose. The NATO course was designed to provide a basis for the integration of physics and technology relevant to the development of hyperthermia. There were 48 lectures covering the theoretical and practical aspects of system design and assessment, including, as far as possible, all the techniques of current interest and importance in the field.
Hyperthermia as a safe and effective cancer treatment modality is rapidly evolving propelled by widespread research and clinical efforts worldwide. Presentations on Hyperthermia experience are now commonplace at Oncology meetings, as are congresses dedicated entirely to the intertwined interactions between basic sciences and patient treatment that together are forming the structure of a new medical specialty. Such was the XII International Symposium on Clinical Hyperthermia held in Rome, Italy, April 27 - 29, 1989. Papers presented therein constitute the backbone of this book. Biology research has provided data describing mechanisms of action for the cancer cell killing and physiological effects of Hyperthermia. Physics research has led to the development of equipment enabling treatment of many areas of the human body, as well as explained the limitations that still constrain our ability to treat, especially in the areas of deep seated tumor heating and non-invasive thermometry. The main question that will decide the future of this modality is that of its clinical use. To put it succinctly, what do we do with this potentially useful tool in an everyday clinical oncological practice . •• ? This is the main question addressed in this book as "Consensus on Hyperthermia for the 1990s. " The book in cludes 28 presented papers and 25 invited chapters from some of the leading experts in the field. Their basic mechanisms of action were physics principles, treatment quality assurance and especially, clinical indications.
The present challenge in the treatment of tumors is to reduce the number of patients that still die as a result of primary tumors. Today, the percentage of such deaths remains high at 30%, even when all the common therapeutic methods, namely surgery, radiotherapy, and chemotherapy, are applied. In order to reduce this percentage, new types of radiation sources with a higher linear energy transfer have been intro duced, such as neutrons and pions. Fractionation patterns have been modified and radiosensitizers have been applied to in crease biological efficiency. Studies of the combined application of chemotherapy and radiotherapy have been made to find the best therapeutic effect. In the early 1970s biological findings confirmed the effect of hyperthermia on tumor cells. The first clinical studies on hyper thermia treatment demonstrated that it resulted in better local tumor control. Further application of this treatment modality showed that hyperthermia should be used in addition to radio therapy and chemotherapy. Despite these encouraging results, hyperthermia has not been introduced into common clinical use, due primarily to technical problems. There are a number of methods of transferring heat into tumors; however, with regard to physical conditions, an op timum method has not yet been found. One of the reasons is that up to now we have had no reliable method of obtaining thermal mapping of all parts of the human body. Such measurements are required not only for dosimetric purposes but also for the regula tion of a hyperthermic system.