Re-setting the biologic rationale for thermal therapy.

Published

Journal Article (Review)

This review takes a retrospective look at how hyperthermia biology, as defined from studies emerging from the late 1970s and into the 1980s, mis-directed the clinical field of hyperthermia, by placing too much emphasis on the necessity of killing cells with hyperthermia in order to define success. The requirement that cell killing be achieved led to sub-optimal hyperthermia fractionation goals for combinations with radiotherapy, inappropriate sequencing between radiation and hyperthermia and goals for hyperthermia equipment performance that were neither achievable nor necessary. The review then considers the importance of the biologic effects of hyperthermia that occur in the temperature range that lies between that necessary to kill substantial proportions of cells and normothermia (e.g. 39-42 degrees C for 1 h). The effects that occur in this temperature range are compelling-including inhibition of radiation-induced damage repair, changes in perfusion, re-oxygenation, effects on macromolecular and nanoparticle delivery, induction of the heat shock response and immunological stimulation, all of which can be exploited to improve tumour response to radiation and chemotherapy. This new knowledge about the biology of hyperthermia compels one to continue to move the field forward, but with thermal goals that are eminently achievable and tolerable by patients. The fact that lower temperatures are incorporated into thermal goals does not lessen the need for non-invasive thermometry or more sophisticated hyperthermia delivery systems, however. If anything, it further compels one to move the field forward on an integrated biological, engineering and clinical level.

Full Text

Duke Authors

Cited Authors

  • Dewhirst, MW; Vujaskovic, Z; Jones, E; Thrall, D

Published Date

  • December 2005

Published In

Volume / Issue

  • 21 / 8

Start / End Page

  • 779 - 790

PubMed ID

  • 16338861

Pubmed Central ID

  • 16338861

International Standard Serial Number (ISSN)

  • 0265-6736

Digital Object Identifier (DOI)

  • 10.1080/02656730500271668

Language

  • eng

Conference Location

  • England