Shortwave diathermy: Combination of Heat With Conventional Cancer Treatment

An irony of conventional chemotherapy cancer treatment is that chemotherapy does not reach hypoxic tumor tissue well, and leaves that to tissue to survive.[1] This shortcoming in efficacy has challenged chemotherapy regimens throughout the present time.  However, diathermic heat is more effective against hypoxic tissue than against well-perfused, well-oxygenated normal tissue.  Therefore, heat may enable chemotherapy to have better effect, so that the effect of combined heat and chemotherapy has been additive.[2]   

Indeed, heat therapy has been found to enhance the cancer-killing (cytotoxic) effect of chemotherapy on cancerous tumors in animals.[3]. Heat also is shown to help overcome the chemotherapy resistance that chemotherapy patients so quickly develop. In this study, heat therapy made cisplatin-resistant tumors sensitive to that drug.[4] It is thought that the increased metabolism stimulated by the heat caused the tumor to uptake more of the drug than under normal bodily temperatures.[5]

Results of those combined treatments were improved with heat treatment compared to no heat treatment at 1, 2, 3, 4, 5 and 8 year patient survival.[6]

Radiation therapy was also shown to combine effectively with heat, multiplying its effectiveness between a factor of 1.2 and 5.[7][8] The synergistic effect of radiation therapy with heat therapy was consistent for all cell lines observed.[9]

Clinical trials of hyperthermia

It has been found that heat treatment alone has eliminated cancer 11%, 13%, 16%, 18% and 45% of the time.[10][11][12][13] Those numbers are taken from studies showing zero percent improvement to 40% improvement with heat alone.

Patients with cancerous lymph nodes in the neck were treated with either radiation alone or radiation with hyperthermia. The latter had more than twice the remission rate than the control group, and their five-year survival went from 0% to 53%.[14][15] In a different study, when a similar comparison was made with the analogous two groups of melanoma patients, the remission increased from 35% to 62% with adding hyperthermia.[16] J van der Zee summarizes results of other clinical trials involving radiation therapy of cancer patients with and without added hyperthermia.[17]

• References

  1. J van der Zee.  Ibid.

  2. J van der Zee.  Ibid.

  3. M Urano, C Ling. Thermal enhancement of melphalan and oxaliplatin cytotoxicity in vitro. Jan 2002. Int J Hyperthermia. https://vivo.weill.cornell.edu/display/pubid12079586

  4. R Cowan, R O’Cearbhaill, et al. Current status and future prospects of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) clinical trials in ovarian cancer. Aug 2018. Int J Hyperthermia.33 (5). 548-553. https://pmc.ncbi.nlm.nih.gov/articles/PMC5776684/#R20

  5. G Los, M van Vugt, et al. Effects of temperature on the interaction of cisplatin and carboplatin with cellular DNA. Oct 1993. Biochem Pharmacol. 46 (7). 1229-1237. https://pubmed.ncbi.nlm.nih.gov/8216374/

  6. Y Huo, A Richards, et al. Hyperthermic intraperiotoneal chemotherapy (HIPEC) and cytoreductive surgery (CRS) in ovarian cancer: A systematic review and meta-analysis. Dec 2015. Eur J Surg Onc. (12) 1578-1589. https://www.ejso.com/article/S0748-7983(15)00771-4/abstract

  7. F Stewart, J Denekamp. The therapeutic advantage of combined heat and X rays on a mouse fibrosarcoma. Br J Radiol Apr 1978, 51 (604). 307-316. https://pubmed.ncbi.nlm.nih.gov/647188

  8. C Marino, A Cividalli. Combined radiation and hyperthermia: Effects of the number of heat fractions and their interval on normal and tumour tissues. Feb 1991. Int J Hyperthermia. 6. https://www.tandfonline.com/doi/abs/10.3109/02656739209005025

  9. H Kampinga, E Dikomey. Hyperthermic radiosensitization: mode of action and clinical relevance. Apr 2001. Int J Radiat Biol. 77 (4). 399-408. https://pubmed.ncbi.nlm.nih.gov/11304434/

  10. P Dunlop, J Hand, et al. An assessment of local hyperthermia in clinical practice. Sep 1985. Int J Hyperthermia. 2 (1). https://www.tandfonline.com/doi/abs/10.3109/02656738609019992

  11. J van der Zee. Healing the patient: A promising approach? Auf 2002. Ann. Oncol. 13 (8). 1173-1184. https://www.annalsofoncology.org/article/S0923-7534(19)63846-9/fulltext

  12. P Gabriele, R Orecchia, et al. Hyperthermia alone in the treatment of recurrences of malignant tumors: Experience with 60 lesions. Nov 1990. Cancer. https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/1097-0142(19901115)66:10%3C2191::AID-CNCR2820661025%3E3.0.CO;2-8

  13. M Manning, T Cetas, et al. Clinical hyperthermia: results of a phase I trial employing hyperthermia alone or in combination with external bean or interstitial radiotherapy. Jan 1982. Cancer. 49 (2). 205-216. https://pubmed.ncbi.nlm.nih.gov/6274503

  14. R Valdagni, M Amichetti, et al. Radical radiation alone versus radical radiation plus microwave hyperthermia for N3 (TNM-UICC neck nodes: a prospective randomized clinical trial. Jul 1988. Int J Rad Onc. 13 (1). 13-24. https://www.redjournal.org/article/0360-3016(88)90341-0/abstract

  15. R Valdagni, M Amichetti. Report of long-term follow-up in a randomized trial comparing radiation therapy and radiation therapy plus hyperthermia to metastatic lymph nodes in stage IV head and neck patients. 1993. Int J Rad Onc. 28. 163-169. https://www.redjournal.org/article/0360-3016(94)90154-6/pdf

  16. J Overgaard, D Gonzalez, et al. Randomised trial of hyperthermia as adjuvant to radiotherapy for recurrent or metastatic malignant melanoma. 1995. Lancet. 345. 540-543. https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(95)90463-8.pdf

  17. J van der Zee. Healing the patient: A promising approach? Auf 2002. Ann. Oncol. 13 (8).