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ABSTRACT: Die regionale Tiefenhyperthermie (RHT) stellt besondere Anforderungen an den Therapeuten. Dadurch, dass ein Tumor in der Tiefe
auf 43°C (oder mehr) erhitzt werden soll, das gesunde Gewebe jedoch geschont werden muss, ergeben sich besondere Schwierigkeiten.
Meist werden für die RHT radiative Radiofrequenzhyperthermiesysteme eingesetzt. Diese lassen sich durch den Einsatz von Hyperthermieplanungssystemen
effektiver betreiben: Die Planung unterstützt den Therapeuten bei der Auswahl der therapierbaren Patienten und ermöglicht
im optimalen Fall eine bis zu 1°C höhere Temperatur bei gleichen Nebenwirkungen. Das kann zu einer Effizienzsteigerung von
theoretisch bis zu 100% führen. Wird die notwendige, therapiebegleitende Temperaturmessung mittels der nichtinvasiven 3D-MR-Thermometrie
durchgeführt, ergibt sich weiteres Verbesserungspotenzial. Durch die zusätzlichen 3D-Informationen, kann die Hyperthermieplanung
während der Therapie an die aktuelle Situation im Sinne einer bildgesteuerten RHT angepasst werden.
Regional deep hyperthermia (RHT) places special demands on therapists: a tumour deep within the body must be heated up to
43°C (or more) and healthy tissue must be preserved, so special difficulties arise. Usually RHT is given by radiant radio
frequency hyperthermia systems. The procedure can be rendered more effective by using hyperthermia treatment planning systems:
planning assists therapists in the selection of those patients who can be treated effectively and makes it possible to raise
the temperature up to 1°C higher with the same side effects in the optimal case. That can lead to increased efficiency, theoretically
up to 100%. If the recommended temperature control during treatment is done by noninvasive 3-D MR thermometry, further improvement
can potentially result. With the additional 3-D information from the images hyperthermia planning can be adapted to the actual
situation, as image-guided RHT.
SchlüsselwörterHyperthermie-Thermische Dosis-Hyperthermieplanung-MR-Thermometrie-Bildgesteuerte Hyperthermie
KeywordsHyperthermia-Thermal dose-Hyperthermia treatment planning-MR thermometry-Image-guided hyperthermia
Der Onkologe 04/2012; 16(11):1052-1062. · 0.17 Impact Factor
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ABSTRACT: The method to acquire MR-temperature datasets by the proton-resonance-shift method is outlined and verified in phantoms and
patients. An online adaptation process has been developed to achieve agreement between planning calculations and MR-temperature
measurements. This is used as a basis to optimize the pattern by a control loop. This procedure is successful after the second
iteration step in phantoms. In patients an increase of SAR (specific absorption rate) in the tumor relative to the surroundings
has been demonstrated for the MR-temperature increase as optimization variable. The optimization results are even improved
under clinical conditions, if perfusion and thermal conduction are considered during the optimization procedure. The mathematical
background is presented.
KeywordsMR-thermography–online-control–optimization–radiofrequency hyperthermia
03/2010: pages 174-175;
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ABSTRACT: An increase in tumor oxygenation and perfusion due to hyperthermia has been reported for experimental tumors. The present study was performed to investigate this hypothesis in patients who underwent regional hyperthermia.
Twenty-seven patients with primary or recurrent pelvic tumors were included in this study. Prior to and up to 1 h after regional hyperthermia, perfusion and partition coefficient were quantitatively determined by utilizing H(2) (15)O-PET. First pass PET images were fused with the segmented common iliac artery from separately acquired CT scan. The arterial input function was extracted from the common iliac arteries using the dynamic PET images and the fused CT. The fused images were also used to extract tumor activity-time curves. Perfusion was calculated from the total tumor curves with correction for arterial spill-over. Changes in perfusion and partition coefficient were analyzed and correlated with various treatment parameters.
Heating under hyperthermia conditions significantly increased the partition coefficient for pelvic tumors (P = 0.005). The increase correlated with the duration of hyperthermia and was found in patients treated for more than 1 h and persisted for more than 1 h after the end. Significant changes in perfusion were not observed. Perfusion had recurred to initial values 20 min after heating.
The increase in partition coefficient reflects an increased diffusion distance of radio-labeled water. Therefore water diffusion is increased due to hyperthermia. Analogous to water diffusion, the diffusion of inert gases is also facilitated, improving the oxygenation of hypoxic tumor cells. Our results suggest that tumor oxygenation can probably be enhanced by regional hyperthermia for a period of more than 1 h after heating, provided hyperthermia is applied for at least 60 min. The effect was observed to be reversible within one week.
International Journal of Hyperthermia 07/2009; 25(4):299-308. · 1.92 Impact Factor
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C. Gimpel,
E. Wuhl,
K. Arbeiter,
D. Drozdz,
A. Trivelli,
M. Charbit, J. Gellermann,
J. Dusek,
A. Jankauskiene,
S. Emre,
F. Schaefer,
ESCAPE Trial Grp
Journal of Hypertension. 01/2009; 27(8):1568-1574.
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E. Wuhl,
A. Peco-Antic,
A. Teixera,
A. Zurowska,
M. Litwin,
S. Picca,
G. Laube,
A. Trivelli,
G. Ardissino,
S. Emre, [......],
T. Urasinski,
A. Jankauskiene,
A. Anarat,
A. Bakkaloglu, J. Gellermann,
D. Drozdz,
S. Mir,
O. Mehls,
F. Schaefer,
ESCAPE Network
Pediatric Nephrology. 01/2009; 24(9):1795-1795.
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E. Wuhl,
A. Trivelli,
S. Picca,
M. Litwin,
A. Peco-Antic,
A. Zurowska,
S. Testa,
A. Jankauskiene,
S. Emre,
A. Caldas-Afonso, [......],
K. Arbeiter,
T. Neuhaus, J. Gellermann,
D. Drozdz,
M. Fischbach,
K. Moller,
M. Wigger,
L. Peruzzi,
O. Mehls,
F. Schaefer
New England Journal of Medicine. 01/2009; 361(17):1639-1650.
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ABSTRACT: Die Prävention und frühzeitige Diagnose der arteriellen Hypertonie bereits im Kindesalter werden zunehmend wichtiger. Die
Medikamente, die für die Therapie im Kindes- und Jugendalter zur Verfügung stehen, werden im vorliegenden Beitrag hinsichtlich
Wirkungsmechanismus, Nebenwirkungen und Dosierungen erörtert. Zur Behandlung geeignet sind ACE-Hemmer, Angiotensin-1-Rezeptor-Antagonisten,
β-Blocker, Diuretika und Kalziumantagonisten. Bei der Auswahl antihypertensiver Medikamente sollten bestehende Komorbiditäten
berücksichtigt werden.
Cardiovascular disease is the most common cause of death in adults, but prevention and early diagnosis of arterial hypertension
in childhood play an important role. This article reviews antihypertensive treatment modalities in childhood. Antihypertensive
drugs are characterized by acting mechanism, dosage recommendation, and side effects. ACE inhibitors, AT1 antagonists, beta blockers, diuretics, and calcium antagonists are the most suitable drugs for treating childhood hypertension.
Preexisting comorbidities should be considered when choosing an antihypertensive drug.
Monatsschrift Kinderheilkunde 10/2008; 156(11):1121-1131. · 0.27 Impact Factor
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ABSTRACT: Online MR-thermometry during hyperthermia can improve treatment control. It needs excellent image quality during hyperthermia treatment to get information from subtracted images.
For hybrid hyperthermia two high-frequency devices were used in combination working with different frequencies. The imaging was performed on a 1.5 T MR tomograph (Siemens Symphony, Quantum Gradienten, Maestro Class, Firma Siemens, Erlangen, Germany) at 64 MHz whereas hyperthermia was administered with a BSD 2000 3D unit utilizing a Sigma Eye applicator and a 12 channel DODECK transistor amplifier (BSD 2000, BSD-MC, Salt Lake City, Utah, USA) operating at 100 MHz. For analysing image artifacts a spectrum analyser (Hewlett Packard HP8591E) was used.
Two different image artifacts, occurring during the use of this hybrid system, are described. The artifacts result from introduction of additional frequencies into the imager. Here we demonstrated the detection and elimination of these spurious frequencies in the context of two case studies.
Hybrid hyperthermia requires excellent imaging for optimal operation. Additional frequencies causing image artifacts can be identified by use of a spectrum analyser. Once identified, these interfering frequencies can be eliminated with appropriate RF filters. With MRI quality control for hyperthermia systems with different treatment frequencies is possible.
International Journal of Hyperthermia 07/2008; 24(4):327-35. · 1.92 Impact Factor
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ABSTRACT: Peritoneal carcinomatosis is a stage of gynecological and gastrointestinal malignancies with poor prognosis. Options for enhancing the effect of standard chemotherapy, such as aggressive surgery and intraperitoneal chemotherapy, have limitations. In this phase I/II study, we evaluated regional hyperthermia of the pelvis and abdomen using the annular-phased-array technique as an adjunct to chemotherapy.
Forty-five patients with peritoneal carcinomatosis (with or without liver metastases) in colorectal cancer (CRC) (n = 16), ovarian cancer (OC) (n = 17), or gastric/pancreatic/biliary cancer (n = 12) underwent standard chemotherapy and regional hyperthermia. Most CRC patients received second-line chemotherapy. All OC patients were platinum resistant. Regional hyperthermia was applied using a SIGMA-60 applicator (OC), a SIGMA-Eye/MR applicator (CRC), or various ring applicators (gastric/pancreatic/biliary cancer).
Abdominal regional hyperthermia was well tolerated, with acceptable acute discomfort and no long-term morbidity. The SIGMA-Eye/MR applicator achieved higher systemic temperatures (associated with higher systemic stress) and more effective heating of the upper abdomen; the SIGMA-60 applicator achieved higher temperatures (and power densities) in the pelvis. Three-year overall survival was encouraging for patients with CRC (22%) and OC (29%) but not gastric/pancreatic/biliary cancer. For the SIGMA-60 applicator (patients with OC), higher measured temperatures at the vaginal stump correlated with better outcome. CONCLUSIONS. The SIGMA-60 and SIGMA-Eye/MR applicators are feasible for abdominal heating and have low toxicity. The SIGMA-60 applicator is specifically suitable for malignancies with high pelvic burden; the SIGMA-Eye/MR applicator better heats the upper abdomen, including the liver. Further randomized investigations are warranted.
International Journal of Hyperthermia 04/2008; 24(5):399-408. · 1.92 Impact Factor
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ABSTRACT: A systematic comparison of three-dimensional MR (magnetic resonance) thermography and planning calculations in phantoms for the hyperthermia (HT) SIGMA-Eye applicator. We performed 2 x 6 experiments in a homogeneous cylindrical and a heterogeneous elliptical phantom by adjusting 82 different patterns with different phase control inside an MR tomograph (Siemens Magnetom Symphony, 1.5 Tesla). For MR thermography, we employed the proton resonance frequency shift method with a drift correction based on silicon tubes. For the planning calculations, we used the finite-difference time-domain (FDTD) method and, in addition, modeled the antennas and the transforming network. We generated regions according to a segmentation of bones and tissue, and used an interpolation technique with a subgrid of 0.5 cm size at the interfaces. A Gauss-Newton solver has been developed to adapt phases and amplitudes. A qualitative agreement between the planning program and measurements was obtained, including a correct prediction of hot spot locations. The final deviation between planning and measurement is in the range of 2-3 W/kg, i.e., below 10%. Additional HT phase and amplitude adaptation, as well as position correction of the phantom in the SIGMA-Eye, further improve the results. HT phase corrections in the range of 30-40 degrees and HT amplitude corrections of +/- 20-30% are required for the best agreement. The deviation /MR-FDTD/, and the HT phase/amplitude corrections depend on the type of phantom, certain channel groups, pattern steering, and the positioning error. Appropriate agreement between three-dimensional specific absorption rate distributions measured by MR-thermography and planning calculations is achieved, if the correct position and adapted feed point parameters are considered. As long as feed-point parameters are uncertain (i.e., cannot be directly measured during therapy), a prospective planning will remain difficult. However, we can use the information of MR thermography to better predict the patterns in the future even without the knowledge of feed-point parameters.
Medical Physics 11/2006; 33(10):3912-20. · 2.83 Impact Factor
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ABSTRACT: Die Hyperthermie (Wrmetherapie) hat bisher keinen Eingang in die onkologische Standardtherapie gefunden. Sie bietet jedoch groe onkologische Potenziale, da sie gut vertrglich ist und sowohl die Radiotherapie als auch die Chemotherapie bei vielen Ausbreitungsstadien verstrken kann. Fr das lokal fortgeschrittene Zervixkarzinom (im Stadium FIGO IIB) wurden mehrere randomisierte Studien durchgefhrt, in denen die hhere lokale Wirksamkeit der hyperthermen Radiotherapie im Vergleich zur Standardradiotherapie belegt werden konnte. Der Einfluss der Hyperthermie auf die Radiochemotherapie wird nun in einer internationalen prospektiven Studie geprft. Auch die properative trimodale Anwendung wurde in einer Phase-II-Studie evaluiert. Darber hinaus gibt es neuere technologische Entwicklungen in der Hyperthermie (Hybridhyperthermie, Nanotherapie und Teilkrperhyperthermie), die insbesondere eine Anwendung in der Behandlung des rezidivierenden Zervixkarzinoms ermglichen (Beckenwandrezidiv und/oder peritoneale Ausbreitung).Hyperthermia has not yet been established as a standard procedure in oncological practice. However, patients tolerate this modality very well, and the effects of radiation therapy as well as chemotherapy were demonstrated to get enhanced in various stages of oncological diseases. Therefore, a high potential benefit can be expected. A number of randomised studies have been performed for locally advanced cervical cancer (stages FIGO IIB) demonstrating an increased local efficacy for hyperthermic radiation therapy compared to radiation alone. The impact of hyperthermia in conjunction with radio-chemotherapy is currently examined in an international prospective study. In addition, a trimodal therapy was evaluated in a neoadjuvant approach as phase II study. Furthermore, hyperthermia is undergoing great technological advances (e.g. hybrid hyperthermia, nanotherapy, and part-body hyperthermia), which enables its use in recurrent cervical cancer, in particular with pelvic wall infiltration and peritoneal involvement.
Der Onkologe 08/2006; 12(9):923-930. · 0.17 Impact Factor
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ABSTRACT: The present study compares quality of life (QoL) after neoadjuvant radiochemotherapy with or without hyperthermia in patients with advanced rectal cancer.
Between April 1994 and May 1999, 137 patients were treated by neoadjuvant radiochemotherapy with (69 patients (50.4%)) or without (68 patients (49.6%)) hyperthermia. Forty-six patients (33.6%) filled-out a 'Gastrointestinal Quality of Life Index' (GIQLI) questionnaire at four time points (before and after neoadjuvant therapy, early after surgery and after long-term follow-up) and were included in the present study.
There were no statistically significant differences in the global GIQLI index between patients treated with neoadjuvant radiochemotherapy with and without hyperthermia at any time point. The longitudinal analysis of GIQLI values in both treatment groups showed specific profiles that were identical in both treatment groups. Occurrence of severe toxicity during the neoadjuvant therapy in both arms lead to a significant temporary reduction of QoL scores at TP2 without any detrimental long-term effects. Patients with sphincter preservation and patients with sphincter resection reported similar QoL scores during long-term follow-up.
Neoadjuvant radiochemotherapy with and without hyperthermia has similar effects on the QoL of patients with locally advanced rectal cancer. The addition of hyperthermia during the neoadjuvant therapy with the potentially associated inconveniences has no negative effects on QoL.
International Journal of Hyperthermia 07/2006; 22(4):301-18. · 1.92 Impact Factor
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ABSTRACT: Non-invasive thermometry (NIT) is a valuable and probably indispensable tool for further development of radiofrequency (RF) hyperthermia. A hybridization of an MRI scanner with a hyperthermia system is necessary for a real-time NIT. The selection of the best thermographic method is difficult, because many parameters and attributes have to be considered.
In the hybrid system (Siemens Symphony/BSD-2000-3D) the standard methods for NIT were tested such as T1, diffusion (ADC: apparent diffusion coefficient) and proton-resonance-frequency shift (PFS) method. A series of three-dimensional datasets was acquired with different gradient-echo sequences, diffusion-weighted EPI spin-echo sequences and calculated MR-temperatures in the software platform AMIRA-HyperPlan. In particular for the PFS-method, corrective methods were developed and tested with respect to drift and other disturbances. Experiments were performed in phantoms and the results compared with direct temperature measurements. Then the procedures were transferred to clinical applications in patients with larger tumours of the lower extremity or the pelvis.
Heating experiments and MR-thermography in a homogeneous cylindrical phantom give an excellent survey over the potentials of the methods. Under clinical conditions all these methods have difficulties due to motion, physiological changes, inhomogeneous composition and susceptibility variations in human tissues. The PFS-method is most stable in patients yielding reasonable MR temperature distributions and time curves for pelvic and lower extremity tumours over realistic treatment times of 60-90 min. Pooled data exist for rectal tumour recurrencies and soft tissue sarcomas. The fat tissue can be used for drift correction in these patients. T1 and diffusion-dependent methods appear less suitable for these patients. The standard methods have different sensitivities with respect to the various error sources. The advantages and pitfalls of every method are discussed with respect to the literature and illustrated by the phantom and patient measurements.
MR-controlled RF hyperthermia in a hybrid system is well established in phantoms and already feasible for patients in the pelvic and lower extremity region. Under optimal conditions the temperature accuracy might be in the range of 0.5 degrees C. However a variety of developments, especially sequences and post-processing modules, are still required for the clinical routine.
International Journal of Hyperthermia 10/2005; 21(6):497-513. · 1.92 Impact Factor
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ABSTRACT: Progress in surgery and adjuvant therapy has markedly improved local control and survival rates in patients with primary, non-metastatic rectal cancer. However, the prognosis of patients with locally recurrent disease is still poor, and a realistic chance for repeated treatment with curative intent is still restricted to the minority of cases. Therefore, effective palliation of symptoms and preservation of a good quality of life are the major goals of therapy for most patients with local recurrence of rectal cancer. Here we give a short overview on the options available for the treatment of pelvic recurrence of rectal cancer, with special focus on adjunctive regional pelvic radiofrequency hyperthermia.
Onkologie 11/2004; 27(5):506-11. · 0.87 Impact Factor
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P Wust, J Gellermann,
M Seebass,
H Fähling,
P Turner,
W Wlodarczyk,
J Nadobny,
B Rau,
B Hildebrandt,
A Oppelt,
P M Schlag,
R Felix
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ABSTRACT: Objective of this study is the integration of a multiantenna applicator for part-body hyperthermia (BSD 2000/3D) in a 1.5 T MR-tomograph (Siemens Magnetom Symphony) in order to perform noninvasive MR monitoring in real time to increase safety and effectiveness of heat treatments. The positioning unit is mechanically coupled to the MR gantry from the back side and the body coil is utilised for imaging. For that purpose, the hyperthermia antenna system (100 MHz, 1.500 W) and the MR receiver (63.9 MHs) have to be decoupled in terms of high frequency (filter) and electromagnetically (emc). The processing of MR data sets is performed in a hyperthermia planning system. A simultaneous operation of radiofrequency hyperthermia and MR system is possible at clinically relevant power levels. MR imaging is used for tumor-diagnostics (standard spin echo sequences), for hyperthermia planning (T1-weighted gradient echo sequences in equal- and opposed-phase techniques), and for temperature measurements according to the proton resonance frequency method (PRF method, phase evaluation registration using a gradient echo sequence with long echo time). In 33 patients with advanced pelvic and abdominal tumors we performed 150 heat sessions under MR monitoring. For 70% of these patients a visualisation of temperature sensitive data during treatment was possible. The evaluated difference images represent a superposition of real temperature -increase and a (temperature-induced) perfusion elevation. The -hybrid approach renders development of part body hyperthermia possible as an MR-controlled intervention in radiology.
RöFo - Fortschritte auf dem Gebiet der R 04/2004; 176(3):363-74. · 2.76 Impact Factor
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ABSTRACT: The extent and onset of obstruction in hydronephrosis determine the varying degrees of renal impairment. Bilateral hydronephrosis, especially in combination with oligohydramnios, is considered a negative predictor for pregnancy outcome. We describe a case of bilateral pelviureteral junction obstruction causing severe oligohydramnios between 25 and 29 weeks of gestation. The prenatal and postnatal findings and treatment are demonstrated. In the presence of bilateral renal impairment and oligohydramnios, our patient had an unfavorable prognosis. The respiratory and renal function, however, were better than expected. We show how urinary tract reconstruction and neonatal intensive therapy can result in an acceptable outcome.
Urology 06/2003; 61(5):1036. · 2.43 Impact Factor
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ABSTRACT: Hyperthermia, the procedure of raising the temperature of tumour-loaded tissue to 40-43 degrees C, is applied as an adjunctive therapy with various established cancer treatments such as radiotherapy and chemotherapy. The potential to control power distributions in vivo has been significantly improved lately by the development of planning systems and other modelling tools. This increased understanding has led to the design of multiantenna applicators (including their transforming networks) and implementation of systems for monitoring of E-fields (eg, electro-optical sensors) and temperature (particularly, on-line magnetic resonance tomography). Several phase III trials comparing radiotherapy alone or with hyperthermia have shown a beneficial effect of hyperthermia (with existing standard equipment) in terms of local control (eg, recurrent breast cancer and malignant melanoma) and survival (eg, head and neck lymph-node metastases, glioblastoma, cervical carcinoma). Therefore, further development of existing technology and elucidation of molecular mechanisms are justified. In recent molecular and biological investigations there have been novel applications such as gene therapy or immunotherapy (vaccination) with temperature acting as an enhancer, to trigger or to switch mechanisms on and off. However, for every particular temperature-dependent interaction exploited for clinical purposes, sophisticated control of temperature, spatially as well as temporally, in deep body regions will further improve the potential.
The Lancet Oncology 09/2002; 3(8):487-97. · 22.59 Impact Factor
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ABSTRACT: Polymorphisms in the genes encoding the high-affinity IgE receptor, the interleukin 4 (IL4) receptor and IL13 can be associated with the development of asthma and allergy. Although several studies have described an association between atopy and idiopathic childhood nephrotic syndrome (NS), it is not clear whether this association is of a causal nature. Furthermore, it is not known whether these polymorphisms are associated with the clinical course of NS. A total of 84 children (52 male and 32 female; mean age 12.1 years) with NS were included in the present study. Of these, 78 could be classified as either atopic or non-atopic. Atopy was defined by elevated IgE levels (>100 k-units/l) and/or a positive history of atopy (33 of 78 patients). DNA was extracted from blood collected in EDTA tubes, and polymorphisms at positions 50 and 551 of the IL4 receptor, position 110 of IL13 and position 181 of the high-affinity IgE receptor were investigated by sequence-specific PCR or direct sequencing. Although we noted a strong tendency towards a higher allele frequency of polymorphisms in children with atopy and NS compared with children with NS but without atopy (IL4 50, 30% compared with 18%; IL4 551, 39% compared with 31%; IL13 110, 45% compared with 33%; IgE 181, 12% compared with 13%), these differences did not reach statistical significance. There were no differences in the frequency of polymorphisms between the different clinical courses of NS (frequent relapsers, steroid-dependent or steroid-resistant NS). We conclude that polymorphisms in the IL4 receptor, the high-affinity IgE receptor and IL13 do not seem to predict the clinical course of NS, despite the fact that serum IgE elevations are more frequent in patients with NS than in normal control subjects. The investigated polymorphisms may contribute to the IgE switch in patients with NS.
Clinical Science 05/2002; 102(5):507-12. · 4.61 Impact Factor
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ABSTRACT: In locally advanced rectal cancer with infiltration of neighbouring organs (uT4), resectability and local control are difficult to achieve. Combined preoperative radiochemotherapy may result in increased resectability and reduced local recurrence rates.
Thirty-four patients with biopsy-proven locally advanced rectal cancer were treated by preoperative radiochemotherapy. All tumours had been staged as uT4 lesions by endorectal ultrasound or computed tomography. Radiotherapy was applied in standard blocks, 5 x 1.8 Gy up to 45 Gy. Chemotherapy consisted of two cycles of 5-fluorouracil (300-350 mg/m2/day) and leucovorin (50 mg). In 20 patients, additional thermotherapy was carried out using the Sigma 60 applicator BSD 2000 once a week prior to radiotherapy. Surgery was performed 4-6 weeks after radiochemotherapy. Postoperatively, all patients received four cycles of 5-fluorouracil and leucovorin.
Treatment-induced toxicity occurred in 26% of the patients (WHO grade III (n = 6) and IV (n = 3)). The resectability rate was 76% (26/34 patients) (R0 resectability n = 21; 62%). The pathological complete response rate was 6% (n = 2) and the partial response rate was 47% (n = 16). A local failure was observed in six patients after median time of 16 months (range 7-36 months). Patients with R0 resection achieved a 5-year disease-free survival rate of 55% and a survival rate of 71%. The overall 5-year survival rate for all patients with advanced uT4 rectal cancer was 49%.
Our data on preoperative combined treatment in locally advanced T4 rectal cancer revealed encouraging downstaging, local control, and survival rates.
Der Chirurg 03/2002; 73(2):147-53. · 0.70 Impact Factor
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ABSTRACT: Clinical hyperthermia (HT) can be divided into: superficial, interstitial, whole-body and deep-body HT. Non-ablative deep heating in the human trunk is a precondition for novel very promising methods of cancer treatment, such as heat-guided modalities of drug targeting and gene expression. Further, a non-invasive monitoring of temperature (and other physiological parameters) in a patient under thermotherapy is required. Thus a combination of HT with clinical monitoring systems, such as a magnetic resonance (MR) scanner, is a consequence. MR methods for temperature monitoring have been developed. The most advanced technology for deep-body heating is based on annular phased arrays (APA) of radiators. We report on recent advances in the technology and techniques of deep-body heating. We present two 3D HT applicators based on different antenna concepts. In this context, we review some recent improvements in modeling patients and HT devices and describe how the compatibility between HT and MR systems has been achieved. Examples of deep heating under simultaneous MR temperature monitoring in phantoms, volunteers and patients are presented.
Antennas and Propagation Society International Symposium, 2002. IEEE; 02/2002
