HYPERTHERMIA IN RECURRENT BREAST CANCER: FROM EXPERIMENTAL ONCOLOGY TO STANDARD PRACTICE

Rietveld J. Van der Zee P.J.M., Broekmeyer-Reurink M.P., Wielheesen D.H.M., Rhoon G.C. Van

We started clinical research on local hyperthermia in breast cancer in 1979. In the first ten years, the research was aimed mainly on development of heating techniques, while at the same time, the clinical results were evaluated. The majority of the patients was treated with hyperthermia in addition to reirradiation. The contribution of hyperthermia to the treatment results was studied in a randomised fashion and appeared to be substantial. Since 1994, the combined treatment is applied standardly to patients with breast cancer recurring in previously irradiated areas. In this paper, some aspects of clinical application of superficial hyperthermia are described. The quality of the available equipment must be known and assured. Only patients should be selected in whom the whole volume to be treated with hyperthermia will receive sufficient energy. The patients need a detailed explanation of the treatment procedure and instructions concerning their own role in monitoring the temperature distribution. The staff should be well trained, well motivated and caring. Further, we find that evaluation of the temperature distribution achieved during each treatment session, before the next treatment is given, is helpful in improving the quality of a treatment series. When necessary, the application technique is adjusted to improve the temperature distribution. In our unit, we achieve 74% complete tumor response in patients with recurrent breast cancer following hyperthermia combined with reirradiation to a total dose of 32 Gy.

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