Regional hyperthermia--assessment of tolerance to treatment

To assess the patient's tolerance and the complications of treatment associated with delivery of regional hyperthermia using APAS BSD equipment, the data on 30 patients who received regional hyperthermia at the Radiation Oncology Center, Washington University School of Medicine, St. Louis, Missouri, has been reviewed. Most patients presented with advanced or recurrent tumors not amenable to conventional treatment modalities. Hyperthermia was administered in combination with either radiotherapy or chemotherapy. Cardiovascular evaluation was a standard part of pre-treatment work-up. Temperatures were obtained through interstitial probes, catheters inserted into the body cavities and (to record core temperature) esophagus. Local discomfort, anxiety, systemic temperature elevation, and tachycardia were the predominant factors limiting the number of sessions, the duration of sessions and the deposition of power, in 18, 6, 3, and 2 patients, respectively. The complications of treatment were rare. Significant injuries of the superficial tissues were recorded in two patients in whom this could be attributed to contact of urine and stool with the skin surface. Neuropathy was observed in two patients, both of whom had pelvic masses adjacent to or invading into the affected nerves. Both patients had received pelvic irradiation. Neuropathy developed within several days after the first hyperthermia session and proved reversible within several months. No injuries of the visceral organs that could be clearly attributed to hyperthermia have been recorded.