Hyperthermia and radiotherapy: physiological basis for a synergistic effect

Area of Science:

• Oncology
• Radiation Oncology
• Biomedical Engineering

Background:

• Mild hyperthermia (HT) is a revived therapeutic approach in cancer treatment.
• HT can potentiate the effects of radiotherapy (RT), widening the therapeutic window.
• HT acts on multiple cellular targets, influencing tumor pathophysiology.

Purpose of the Study:

• To review the synergistic effects of combining hyperthermia with radiotherapy.
• To describe the phenomena of thermal shock and thermotolerance in cancer treatment.
• To stimulate novel clinical concepts and combinations involving HT and RT.

Main Methods:

• Literature review focusing on the mechanisms of HT and RT combination therapy.
• Analysis of pathophysiological effects including DNA damage/repair, hypoxia, stemness, and immunostimulation.
• Discussion of thermal shock and thermotolerance phenomena.

Main Results:

• HT and RT combination demonstrates synergistic antitumoral effects.
• HT impacts DNA repair, hypoxia, stemness, and immune responses.
• Thermal shock can lead to direct tumor cell kill, while thermotolerance is a temporary resistance post-HT.

Conclusions:

• Understanding HT mechanisms is essential for clinical trial development.
• The combination of HT and RT offers enhanced efficacy in cancer treatment.
• Novel therapeutic strategies integrating HT, RT, and immunotherapy are promising.