Regional Thermotherapy

Abstract

A broad range of temperatures is useful in oncology. Thermoablation (heat alone) requires temperatures of >45 to 50°C and is only clinically possible in circumscribed lesions. High-intensity focused ultrasound (HIFU) and nanotherapy are suitable methods. The largest volume heated is the whole body, using whole-body hyperthermia (WBHT); 42°C is the highest temperature permitted. Clinical experience and some positive studies suggest, however, that higher temperatures (e.g., 43°C) are required at least in certain specific (e.g., hypoxic) parts of the tumors to increase local control in conjunction with radiotherapy and/or chemotherapy and to be beneficial for patients. Dedicated multiantenna applicators operating in the radiofrequency range (60–200 MHz) must be designed for each indication accounting for the anatomical region. Magnetic resonance monitoring is the first candidate for noninvasive control. The technical problems have been solved to integrate such applicators into an MR-tomograph. Although commercially available systems (for regional hyperthermia) are adequate for pelvic and extremity tumors, adaption/optimization is still desired for abdominally disseminated disease. Here, the termpartbody hyperthermia has been created, for which a large number of clinical indications (gastrointestinal tumors) exist.