CONDUCTIVE INTERSTITIAL HYPERTHERMIA IN THE TREATMENT OF INTRACRANIALMETASTATIC DISEASE

Background: Intracranial metastases commonly complicate oncologic care affecting 140,000 patients per year in the United States. Treatment o f these tumors is difficult and often unsuccessful. Hyperthermia is a treatment alternative that has shown promise in treating cancer in oth er areas. Therefore it was employed in an attempt to provide increased tumor control in CNS metastases. Methods: This Phase I and Phase II c linical trial of interstitial hyperthermia in 13 patients with recurre nt or progressive intracranial metastatic disease was undertaken to ev aluate complications, delivery of heat and patient outcome. Results: F eared complications of clinically significant bleeding, increased mass , or infection from the interstitial implant and treatment did not occ ur. The seizures which occurred in 4 patients were controlled with add itional anticonvulsants. Three venous thromboembolic events were treat ed medically and with percutaneously placed inferior vena cava filters . The KPS of the majority of patients declined slightly with treatment but rebounded to near baseline within several months. CT scans demons trated decrease or stabilization of tumor volumes in 7 of the 13 patie nts. In 4 of these patients, regression or stabilization persisted unt il death from nonCNS disease. Conclusions: Interstitial hyperthermia t herapy for intracranial metastases is technically feasible and may pro vide increased tumor control. In this small series, it did not cause u nreasonable complications. This therapy has some positive effect, but requires study of more patients before its role is definitively known. Combining hyperthermia with brachytherapy and/or chemotherapy is bein g evaluated. The opinions and assertions contained herein are the priv ate views of the authors and are not to be construed as official or as reflecting the views of the Department of Defense.