Radio-Thermotherapy in Multimodal Surgical Treatment Concepts

Hyperthermia can play a role in curative multimodal therapies of locally advanced malignancies. Firstly, the downstaging rate can be increased in pre-operative therapies (resectability, organ preservation), and secondly the local control can be improved. The synergistic effect of hyperthermia at 42-43 °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 drugs and un-specific as well as specific immunological processes, the value of which for clinical application has not yet been determined. The future of the clinical use of hyperthermia will be determined to a large extent by developments and improvements in the technology used, and the greatest potential lies in advancing radiofrequency equipment. Infrared whole-body hyperthermia also made progress in the past few years. We outline oncological concepts to apply hyperthermia for advanced rectal carcinomas, carcinomas of the bladder, oesophageal carcinomas and soft-tissue sarcomas. In this work we summarise results relating to hyperthermia performed on these tumour entities and details of possible therapeutic strategies. We also look at technical approaches to improved quality control of the heat delivery device, as well as planning, monitoring and verification of power application and temperature distribution.