Current and potential role of thermoradiotherapy for solid tumours

Area of Science:

• Oncology
• Radiation Oncology
• Medical Physics

Background:

• Conventional radiotherapy alone shows disappointing results for inoperable, locally advanced, or recurrent solid tumors.
• Radiochemotherapy has demonstrated benefits in local tumor control and survival for several tumor types.
• Radiofrequency hyperthermia offers a method to intensify the effects of radio- and chemotherapy.

Purpose of the Study:

• To evaluate the efficacy of combining hyperthermia with radiation therapy for various solid tumors.
• To assess the impact of hyperthermia on local tumor control and patient survival.
• To explore the potential of hyperthermia in multimodal treatment strategies for advanced cancers.

Main Methods:

• Analysis of 11 randomized phase III trials involving over 1,000 patients.
• Inclusion of hyperthermia treatment at 40-42°C for at least 1 hour combined with radiation therapy.
• Review of trial data focusing on local tumor control and survival benefits.

Main Results:

• The combination of hyperthermia and radiation therapy proved effective for local tumor control in 11 trials.
• Two trials demonstrated a significant survival benefit, such as a 3-year survival improvement from 27% to 51% in locally advanced cervical cancer.
• Most trials did not show a survival benefit due to design limitations, small patient numbers, or short follow-up periods.

Conclusions:

• Thermoradiotherapy shows promise for improving local tumor control and survival in specific advanced cancers.
• Further investigation is warranted to determine hyperthermia's role in combination with radiochemotherapy and in multimodal strategies.
• Optimizing temperature monitoring, distribution, and patient selection is crucial for maximizing hyperthermia's benefits.