Whole body hyperthermia in the treatment of neoplastic disease

Hyperthermia, the elevation of body or tissue temperature, has been used to treat various ailments including cancer since ancient times. During the past 15 years, laboratory evidence has developed to provide a scientific rationale for its use in the treatment of neoplastic diseases. Generally, temperatures in excess of 41 degrees C in vitro will kill neoplastic cells exponentially as a function of time. The direct cytotoxic effects of heat alone, however, may have limited clinical utility due to poor response rates and response durations. The greatest potential of hyperthermia resides in its use as an adjunct to other forms of therapy. As hyperthermia is nonmyelosuppressive and can potentiate the tumoricidal effects of radiation, chemotherapy, and immunotherapy, its use as part of a multimodality treatment approach is attractive. Three forms of hyperthermia have been developed for clinical application: local, regional, and whole body. As WBH addresses the issue of cancer as a systemic disease, it has perhaps the greatest potential for curative success when used as an adjunct to other therapeutic modalities. Using a variety of WBH methodologies, core temperatures have been maintained at 41 degrees C or 42 degrees C in humans for several hours with variable morbidity and occasional mortality. Most systems for WBH include a requirement for general anesthesia, as well as complex equipment to regulate patient temperature. The system most used to date worldwide is based on extracorporeal heating. A hot water suit system, developed at the National Cancer Institute, has also undergone extensive testing.(ABSTRACT TRUNCATED AT 250 WORDS)