Evaluating radiation in combination with hyperthermia trials: the importance of clinical and technical parameters

A proper evaluation of hyperthermia and irradiation trials is necessary to correctly interpret clinical results and to define limitations and properties of this new therapeutic approach. A better understanding of the "weight" of different technologic and clinical parameters that influence clinical response is thus clearly needed, particularly if future advances in hyperthermia technology and clinical results are to be expected. Patient variables, tumor variables, and treatment characteristics have been analyzed, and the difficulties of properly evaluating the "weight" of single parameters have been stressed. At the current state of knowledge, the Karnofsky index, site of disease (for regional heating), tumor status (recurrent versus metastatic disease) and XRT dose per fraction (for melanomas) seem to correlate with response. Tumor dimension, XRT total dose and thermal parameters reflecting the lowest tumor temperatures appear to statistically influence complete response rates of heated and irradiated tumors. In addition, a critical method of presenting results should be followed to enable comparison of data from different trials.