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The use of hyperthermia in radiation oncology is well established. Many publications cover the whole field of possibilities and problems of this therapeutic modality. The new development of interstitial and intracavitary hyperthermia, however, is not well known: there are only a few relevant publications in different journals. Therefore, it was appropriate that SAUER and SEEGENSCHMIEDT organized an international meeting on this topic, where experiences with this new and promising technique were compiled and discussed by experts. The papers of this symposium together with additional review papers and clinical studies are published in this volume. The publication begins with the physical and biological background of interstitial and intracavitary hyperthermia continues with comprehensive review papers on clinical topics and then gives examples for a wide variety of clinical applications. This volume will contribute to better understanding and application of the treatment possibilities of radio oncology in combination with this new treatment modality.
The use of hyperthermia in radiation oncology is well established. Many publications cover the whole field of possibilities and problems of this therapeutic modality. The new development of interstitial and intracavitary hyperthermia, however, is not well known: there are only a few relevant publications in different journals. Therefore, it was appropriate that SAUER and SEEGENSCHMIEDT organized an international meeting on this topic, where experiences with this new and promising technique were compiled and discussed by experts. The papers of this symposium together with additional review papers and clinical studies are published in this volume. The publication begins with the physical and biological background of interstitial and intracavitary hyperthermia continues with comprehensive review papers on clinical topics and then gives examples for a wide variety of clinical applications. This volume will contribute to better understanding and application of the treatment possibilities of radio oncology in combination with this new treatment modality.
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 ionizing radiation when used locally but also has been of help in combination with systemic chemotherapy where hyperthermia is carried out to the total body. Triple modality (thermo-chemo-radiotherapy) or other treatment combinations have not been fully evaluated and may demonstrate extended clinical applications in the future. Problems remain with regard to maximizing the effects of hyperthermia as they are influenced by a variety of external and intrinsic factors including bloodflow, microenvironment etc. While the previous volume has summarized more theoretical aspects of hyper thermia, i.e. biology, physiology and physics, the present volume compiles the current knowledge relative to the clinical applications of hyperthermia in combina tion with radiation therapy and/or chemotherapy, providing a comprehensive over view of its use in cancer management.
"Internal" hyperthermia is a type of thermotherapy by which heat is sup plied to tumor tissue in situ. There are three different techniques for pro viding internal hyperthermia: (1) interstitial hyperthermia using implanted needle probes, (2) intracavitary hyperthermia using probes introduced into natural body cavities, and (3) perfusional hyperthermia by means of ex tracorporal blood heating. Compared with external hyperthermia, internal hyperthermia has been preferentially accepted by oncologists because it can be more easily combined with other forms of treatment, e. g., interstitial thermotherapy with brachytherapy, or perfusional hyperthermia with che motherapy. Various types of equipment for interstitial and intracavitary thermotherapy have been developed and used quite extensively in clinical trials, generally in combination with radiation therapy. There are four different methods for producing interstitial or intracavitary hyperthermia, each related to different types of heating. Most studies have been performed using radiofrequency electrodes (resistive heating) or coaxial microwave antennas (radiative heating). Recently, however, "hot source" techniques that rely on thermal conduction and blood flow convection for heat transport have found clinical application. These techniques include ferromagnetic implants activated by hot water or by electrical means. In the near future, new methods for in terstitial or intraluminal heating based upon advanced ultrasonic and laser technologies will be developed.
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.
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 ionizing radiation when used locally but also has been of help in combination with systemic chemotherapy where hyperthermia is carried out to the total body. Triple modality (thermo-chemo-radiotherapy) or other treatment combinations have not been fully evaluated and may demonstrate extended clinical applications in the future. Problems remain with regard to maximizing the effects of hyperthermia as they are influenced by a variety of external and intrinsic factors including bloodflow, microenvironment etc. While the previous volume has summarized more theoretical aspects of hyper thermia, i.e. biology, physiology and physics, the present volume compiles the current knowledge relative to the clinical applications of hyperthermia in combina tion with radiation therapy and/or chemotherapy, providing a comprehensive over view of its use in cancer management.
"Internal" hyperthermia is a type of thermotherapy by which heat is sup plied to tumor tissue in situ. There are three different techniques for pro viding internal hyperthermia: (1) interstitial hyperthermia using implanted needle probes, (2) intracavitary hyperthermia using probes introduced into natural body cavities, and (3) perfusional hyperthermia by means of ex tracorporal blood heating. Compared with external hyperthermia, internal hyperthermia has been preferentially accepted by oncologists because it can be more easily combined with other forms of treatment, e. g., interstitial thermotherapy with brachytherapy, or perfusional hyperthermia with che motherapy. Various types of equipment for interstitial and intracavitary thermotherapy have been developed and used quite extensively in clinical trials, generally in combination with radiation therapy. There are four different methods for producing interstitial or intracavitary hyperthermia, each related to different types of heating. Most studies have been performed using radiofrequency electrodes (resistive heating) or coaxial microwave antennas (radiative heating). Recently, however, "hot source" techniques that rely on thermal conduction and blood flow convection for heat transport have found clinical application. These techniques include ferromagnetic implants activated by hot water or by electrical means. In the near future, new methods for in terstitial or intraluminal heating based upon advanced ultrasonic and laser technologies will be developed.
The field of thermal therapy has been growing tenaciously in the last few decades. The application of heat to living tissues, from mild hyperthermia to high-temperature thermal ablation, has produced a host of well-documented genetic, cellular, and physiological responses that are being researched intensely for medical applications, particularly for treatment of solid cancerous tumors using image guidance. The controlled application of thermal energy to living tissues has proven a great challenge, requiring expertise from multiple disciplines, thereby leading to the development of many sophisticated pre-clinical and clinical devices and treatment techniques. Physics of Thermal Therapy: Fundamentals and Clinical Applications captures the breadth and depth of this highly multidisciplinary field. Focusing on applications in cancer treatment, this book covers basic principles, practical aspects, and clinical applications of thermal therapy. An overview of the fundamentals shows how use of controlled heat in medicine and biology involves electromagnetics, acoustics, thermodynamics, heat transfer, and imaging sciences. The book discusses challenges in the use of thermal energy on living tissues and explores the genetic, cellular, and physiological responses that can be employed in the fight against cancer from the physics and engineering perspectives. It also highlights recent advances, including the treatment of solid tumors using image-guided thermal therapy, microbubbles, nanoparticles, and other cutting-edge techniques.