OPTIMIZATION OF CHEMOTHERAPY ADMINISTRATION FOR CLINICAL 41.8-DEGREES-C WHOLE-BODY HYPERTHERMIA

Preclinical data is consistent with the concept that the timing of che motherapy during radiant heat-whole body hyperthermia (WBH) should aff ect therapeutic index. In order to test this hypothesis, a controlled clinical investigation was initiated. Patients received carboplatin (C BDCA) on an early or late schedule with respect to achieving target te mperature (i.e. 41.8 degrees C) in alternating treatment cycles. The f irst cycle was randomized between patients regarding the early or late schedule for two planned sets per patient (i.e. four cycles). Ifosfam ide, etoposide and granulocyte colony stimulating factor were delivere d during all cycles with a standardized schedule. A total of 53 cycles involving 17 patients were analyzed. Detailed toxicity evaluation (i. e. delay in therapy secondary to thrombocytopenia, need for platelet t ransfusions, and days of hospitalization) taken collectively demonstra ted a statistically and clinically significant advantage to delivering CBDCA 10 min after target temperature, during the plateau phase of WB H. (C) 1997 Elsevier Science Ireland Ltd.