RADIO-THERMOTHERAPY IN MULTIMODAL SURGICA L-TREATMENT CONCEPTS

Hyperthermia can play a role in curative multimodal therapies of local ly advanced malignancies. Firstly, the downstaging rate can be increas ed in pre-operative therapies (resectability, organ preservation), ari d secondly the local control can be improved. The synergistic effect o f hyperthermia at 42-43 degrees C when combined with radiotherapy has been demonstrated in pre-clinical studies and in phase III studies as well. Furthermore, there are interactions with numerous cytotoxic drug s and unspecific as well as specific immunological processes, the valu e of which for clinical application has not yet been determined. The f uture of the clinical use of hyperthermia will be determined to a larg e extent by developments and improvements in the technology used, and the greatest potential lies in advancing radiofrequency equipment. Inf rared whole-body hyperthermia also made progress in the past few years . We outline oncological concepts to apply hyperthermia for advanced r ectal carcinomas, carcinomas of the bladder, oesophageal carcinomas an d soft-tissue sarcomas. In this work we summarise results relating to hyperthermia performed on these tumour entities and details of possibl e therapeutic strategies. We also look at technical approaches to impr oved quality control of the heat delivery device, as well as planning, monitoring and verification of power application and temperature dist ribution.