Analysis of prognostic variables in hyperthermia treatment of 161 patients

• Published in: International journal of radiation oncology, biology, physics Vol. 10; no. 12; pp. 2231 - 2239
• Main Authors: Oleson, James R, Sim, Dalice A, Anning, Michael R
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01.12.1984; Elsevier
• Subjects: Aged; Biological and medical sciences; Combined Modality Therapy; Female; Humans; Hyperthermia; Hyperthermia techniques; Hyperthermia, Induced - adverse effects; Hyperthermia, Induced - methods; Induced hyperthermia. Cryotherapy; Intratumoral temperatures; Male; Medical sciences; Middle Aged; Neoplasms - drug therapy; Neoplasms - radiotherapy; Neoplasms - therapy; Prognosis; Prognostic variables; Treatment with physical agents; Treatment. General aspects; Tumor volume; Tumors; Intratumoral temperatures; Hyperthermia techniques; Tumor volume; Prognostic variables; Hyperthermia; Phase I trial; Instrumentation therapy; Tumor; Prognosis; Technique; Induced hyperthermia
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/0360-3016(84)90228-1

From 1977–1982, 161 patients were treated using hyperthermia as an adjuvant in Phase I trials. Microwave applicators (MW), capacitively coupled plates (RF plates), interstitial localized current fields (LCF), and magnetic induction heating (MI) techniques were used together with radiation in 135 patients, with chemotherapy in 10 patients, and alone in 16 patients. Tumor volume response categories were no response (NR, less than 50% decrease); partial response (PR, 50% ⪕ volume decrease < 100%); and complete response (CR, complete disappearance). The CR rates and total response rates (CR + PR) were 38/160 (24%) and 90/160 (56%), respectively. There were highly significant differences among techniques in CR vs PR + NR ( p = .001), and in CR + PR vs NR ( p < .0005). Response did not vary significantly with histologic category. Overall toxicity was 16%, and did not vary significantly with technique ( p = .193). In the patient group treated with hyperthermia and radiation, multivariate analysis revealed that a set of three variables had prognostic importance for CR: technique ( p = .011), radiation dose ( p = .019), and tumor volume ( p = .001, negatively correlated). A good correlation also existed between CR and the minimum tumor temperature averaged over all treatments, T MIN (P < .0005 ). Temperature variables themselves were correlated with tumor volume. Minimum T correlated negatively with volume ( p = .017) and T MAX correlated positively with volume ( p = .026). In fewer than 50% of patients could minimum T > 40.7° C be achieved. Our conclusions are: 1) T MIN , tumor volume, radiation dose, and heating technique have prognostic value for initial response; 2) variation in CR vs technique reflects variation in tumor volume treated and in minimum temperature achieved with these techniques; and 3) acute toxicity of treatment is infrequent, but serious toxicity is possible with the interstitial technique.