Skip to main content

Advertisement

SpringerLink
Log in

Regional deep hyperthermia in combination with whole brain radiotherapy (WBRT) in poor prognosis patients with brain metastases

  • Brief Research Article
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study is to assess for the first time, the role of regional deep hyperthermia in combination with radiotherapy and systemic therapy in patients with poor prognosis of brain metastases (GPI ≤ 2.5).

Methods

Patients with confirmed cerebral metastases and classified as GPI score ≤ 2.5 were included in this prospective study. Pretreatment stratification was defined as patients with 0–1 GPI score (Group A) and patients with 1.5–2.5 GPI score (Group B). HT was applied twice a week, 60 min per session, during RT by regional capacitive device (HY-DEEP 600WM system) at 13.56 MHz radiofrequency.

Results

Between June 2015 and June 2017, 15 patients and a total of 49 brain metastases were included in the protocol. All patients received all HT sessions as planned. RT and systemic therapy were also completed as prescribed. Tolerance to treatment was excellent and no toxicity was registered. Patients with HT effective treatment time longer than the median (W90time > 88%) showed better actuarial PFS at 6 and 12 months (100% and 66.7%, respectively) compared to those with less HT effective treatment time (50% and 0%, respectively) (p < 0.031). Median OS was 6 months (range 1–36 months). Stratification by GPI score showed a median OS of 3 months (CI 95% 2.49–3.51) in Group A and 8.0 months (CI 95% 5.15–10.41) in Group B (p = 0.035).

Conclusions

Regional hyperthermia is a feasible and safe technique to be used in combination with RT in brain metastases patients, improving PFS and survival in poor prognostic brain metastasis patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Nayak L, Lee EQ, Wen PY. Epidemiology of brain metastases. Curr Oncol Rep. 2012;14(1):48–544. https://doi.org/10.1007/s11912-011-0203-y.

    Article  PubMed  Google Scholar 

  2. Nieder C, Mehta MP. Prognostic indices for brain metastases–usefulness and challenges. Radiat Oncol. 2009;4(4):10. https://doi.org/10.1186/1748-717X-4-10.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sperduto PW, Chao ST, Sneed PK, et al. Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: a multi-institutional analysis of 4,259 patients. Int J Radiat Oncol Biol Phys. 2010;77(3):655–61. https://doi.org/10.1016/j.ijrobp.2009.08.025.

    Article  PubMed  Google Scholar 

  4. Crezee H, van Leeuwen CM, Oei AL, et al. Thermoradiotherapy planning: Integration in routine clinical practice. Int J Hyperth. 2015;32(1):41–9. https://doi.org/10.3109/02656736.2015.1110757.

    Article  Google Scholar 

  5. Dewhirst MW, Vujaskovic Z, Jones E, et al. Re-setting the biologic rationale for thermal therapy. Int J Hyperth. 2005;21(8):779–90. https://doi.org/10.1080/02656730500271668.

    Article  Google Scholar 

  6. Peeken JC, Vaupel P, Combs SE. Integrating hyperthermia into modern radiation oncology: what evidence is necessary? Front Oncol. 2017;7:132. https://doi.org/10.3389/fonc.2017.00132.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Vernon CC, Hand JW, Field SB, et al. Radiotherapy with or without hyperthermia in the treatment of superficial localized breast cancer: results from ve randomized controlled trials. International Collaborative Hyperthermia Group. Int J Radiat Oncol Biol Phys. 1996;35(4):731–44. https://doi.org/10.1016/0360-3016(96)00154-X.

    Article  CAS  PubMed  Google Scholar 

  8. van der Zee J, González González D, van Rhoon GC, et al. Comparison of radiotherapy alone with radiotherapy plus hyperthermia in locally advanced pelvic tumours: a prospective, randomised, multicentre trial. Dutch Deep Hyperthermia Group. Lancet. 2000;355(9210):1119–25. https://doi.org/10.1016/S0140-6736(00)02059-6.

    Article  PubMed  Google Scholar 

  9. Kang M, Liu WQ, Qin YT, et al. Long-term efficacy of microwave hyperthermia combined with chemoradiotherapy in treatment of nasopharyngeal carcinoma with cervical lymph node metastases. Asian Pac J Cancer Prev. 2013;14(12):7395–400. https://doi.org/10.7314/APJCP.2013.14.12.7395.

    Article  PubMed  Google Scholar 

  10. De Haas-Kock DFM, Buijsen J, Pijls-Johannesma M, et al. Concomitant hyperthermia and radiation therapy for treating locally advanced rectal cancer. Cochrane Database Syst Rev. 2009;3:CD006269. https://doi.org/10.1002/14651858.CD006269.

    Article  Google Scholar 

  11. Datta NR, Puric E, Klingbiel D, et al. Hyperthermia and radiation therapy in locoregional recurrent breast cancers: a systematic review and meta-analysis. Int J Radiat Oncol Biol Phys. 2016;94(5):1073–87. https://doi.org/10.1016/j.ijrobp.2015.12.361.

    Article  PubMed  Google Scholar 

  12. Lutgens LCHW, Koper PCM, Jobsen JJ, et al. Radiation therapy combined with hyperthermia versus cisplatin for locally advanced cervical cancer: results of the randomized RADCHOC trial. Radiother Oncol. 2016;120(3):378–82. https://doi.org/10.1016/j.radonc.2016.02.010.

    Article  CAS  PubMed  Google Scholar 

  13. Byun YH, Gwak HS, Kwon JI, et al. Local recurrence of brain metastasis reduced by intra-operative hyperthermia treatment. Int J Hyperth. 2018;35(1):168–75. https://doi.org/10.1080/02656736.2018.148800.

    Article  Google Scholar 

  14. Lloret M, García-Cabrera L, Hernandez A, et al. Feasibility of a deep hyperthermia and radiotherapy programme for advanced tumors: first Spanish experience. Clin Transl Oncol. 2019. https://doi.org/10.1007/s12094-019-02097-9.

    Article  PubMed  Google Scholar 

  15. Sahinbas H, Rosch M, Demiray M. Temperature measurements in a capacitive system of deep loco-regional hyperthermia. Electromagn Biol Med. 2017;36(3):248–58. https://doi.org/10.1080/15368378.2017.1307221.

    Article  CAS  PubMed  Google Scholar 

  16. Bruggmoser G, Bauchowitz S, Canters R, et al. Quality assurance for clinical studies in regional deep hyperthermia. Strahlenther Onkol. 2011;187(10):605–10. https://doi.org/10.1007/s00066-011-1145-x.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Dr. Negrin Hospital, Barranco de La Ballena s/n, 35010, Las Palmas de Gran Canaria, Spain

    M. Lloret, L. García-Cabrera & M. Zajac

  2. Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain

    M. Lloret

  3. Instituto Canario de Investigación del Cáncer, Las Palmas de Gran Canaria, Spain

    M. Lloret & P. C. Lara

  4. Universidad Fernando Pessoa Canarias, Las Palmas, Spain

    P. C. Lara

  5. Department of Oncology, Hospital Universitario San Roque, Las Palmas, Spain

    P. C. Lara

Authors
  1. M. Lloret
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. García-Cabrera
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Zajac
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. C. Lara
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Lloret.

Ethics declarations

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

The study was approved by the Ethic Committee and registered under Eudract number 2018-001089-40.

Informed consent

Written inform consent for treatment was obtained from all patients.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lloret, M., García-Cabrera, L., Zajac, M. et al. Regional deep hyperthermia in combination with whole brain radiotherapy (WBRT) in poor prognosis patients with brain metastases. Clin Transl Oncol 23, 190–194 (2021). https://doi.org/10.1007/s12094-020-02404-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12094-020-02404-9

Keywords

Search

Navigation