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Cardiovascular changes during whole body hyperthermia treatment of advanced malignancy

  • N. S. Faithfull
  • H. S. Reinhold
  • A. P. van den Berg
  • G. C. van Rhoon
  • J. van der Zee
  • J. L. Wike-Hooley
Article

Summary

Cardiovascular studies were carried out on patients subjected to whole body hyperthermia treatment for advanced malignancy in order to assess the magnitude of the changes occurring and the degree of strain imposed on the system. The subjects, who were anaesthetised with a nitrous oxide/oxygen and relaxant sequence, were heated in a modified Siemens hyperthermia cabin and maintained at a body temperature of 41.8‡ C for 2 h. The results of 30 treatments are presented. Large increases in cardiac output and heart rate were accompanied by large decreases in peripheral resistance in both the systemic and pulmonary vascular beds. The pulmonary arterial pressure rose whereas that in the systemic circulation fell. This caused right ventricular work to increase proportionately more than left ventricular work. Care should be exercised when subjecting patients with limited right ventricular function to this treatment.

Key words

Hyperthermia Cardiovascular changes Human Malignancy treatment 

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References

  1. Barlogie B, Corry PM, Yip E, Lippman L, Johnson DA, Khalil K, Tenczynski TF, Reilly E, Lawson R, Dosik G, Rigor B, Hankenson R, Freireich EJ (1979) Total Body Hyperthermia with and without chemotherapy for advanced human neoplasms. Cancer Res 3: 1481–1489Google Scholar
  2. Blair RM, Levin W (1977) Clinical experience of the induction and maintenance of whole body hyperthermia. In: Streffer C (ed) Proceedings of the Second: International Symposium on Cancer Therapy by Hyperthermia and Radiation. Urban and Schwarzberg, Baltimore and Munich, pp 318–321Google Scholar
  3. Bull TM, Less D, Schuette W, Whang-Peng J, Smit R, Bynum G, Atkinson ER, Gottdiener JS, Gralnick HR, Shawker TH, DeVita VT (1979) Whole body hyperthermia: A phase 1 trial of a potent adjuvent to chemotherapy. Ann Int Med 90: 317–323Google Scholar
  4. Busch W (1866) über den Einfluss welchen heftigere Erysipelen zuweilen auf organisierte Neubildunern ausüben. Verh Naturh Preuss Rheinl 23: 28–30Google Scholar
  5. Bynum GD, Pandolf KB, Schuette WH, Gildman RF, Lees DE, Whang-Peng J, Atkinson ER, Bull JM (1978) Induced hyperthermia in sedated humans and the concept of critical thermal maximum. Am J Physiol 235: R228–236Google Scholar
  6. Caro CG, McDonald DA (1961) The relation of pulsatile pressure and flow in the pulmonary vascular bed. J Physiol 157: 426–453Google Scholar
  7. Cooley WB (1983) The treatment of malignant tumors by repeated innoculations of erysipelas. Am J Med Sci 105: 487–511Google Scholar
  8. Dubois M, Sato S, Lees DE, Bull JM, Smith R, White BG, Moore H, Macnamara TE (1980) Electro-encephalographic changes during whole body hyperthermia in humans. Electroenceph Neurophysiol 50: 486Google Scholar
  9. Euler-Rolle J, Priesching A, Vormittag E, Tschakaloff C, Polterauer P (1977) Prevention of cardiac complications during whole body hyperthermia by beta receptor blockage. In: Streffer C (ed) Proceedings of the Second International Symposium on Cancer Therapy by Hyperthermia and Radiation. Urban and Schwarzberg, Baltimore and Munich, pp 302–305Google Scholar
  10. FoËx P (1980) In: Prys-Roberts C (ed) The circulation in anaesthesia. Blackwell Scientific Publications, Oxford, Edinburgh, Melbourne, pp 253–263Google Scholar
  11. Greenlaw RH, Loshek DD, Swamy PG, Doyle LA (1980) Clinical trial of whole body hyperthermia by the Pettigrew Method. Abstracts of the Third International Symposium on Cancer Therapy by Hyperthermia and Radiation. June 22–26, Fort Collins, Colorado, p 125Google Scholar
  12. Kaplan AJ (1979) In: Kaplan JA (ed) Cardiac anesthesia. Grune and Stratton, New York, San Francisco and London, p 95Google Scholar
  13. Kim YD, Lake CR, Lees DL, Schuette WH, Bull JM, Weise V, Kopin J (1979) Hemodynamic and plasma catecholamine responses to hyperthermic cancer therapy in humans. Am J Physiol 237: H570–574Google Scholar
  14. Larkin JM, Edwards WS, Smith DE, Clarke PJ (1977) Systemic thermotherapy: description of a method and physiologic tolerance in clinical subjects. Cancer 40: 3155–3159Google Scholar
  15. Lees DE, Kim YD, Bull JM, Whang-Peng J, Schuette W, Smith R, Macnamara TE (1980) Anaesthetic management of whole body hyperthermia for the treatment of cancer. Anesthesiology 52: 418Google Scholar
  16. Loshek DD, Greenlaw RH, Doyle LA (1980) Whole body hyperthermia using a water circulator. Strahlentherapie 157: 620Google Scholar
  17. MacKenzie A, McLeod K, Cassels-Smith AJ, Dickson JA (1975) Total body hyperthermia: Techniques and patient management. Proceedings of the International Symposium on Cancer Therapy by Hyperthermia and Radiation. Washington DC, USA, pp 272–281Google Scholar
  18. Milnor WR, Bergel DH, Bargainer JD (1966) Hydraulic power associated with pulmonary blood flow and its relation to heart rate. Circ Res 19: 467–480Google Scholar
  19. Moricca G, Cavaliere R, Lopez M, Caputo A (1979) Combined whole body hyperthermia and chemotherapy in the treatment of advanced cancer with diffuse pain. In: Bonica JJ, Ventafridda V (eds) Advances in pain research and therapy, vol 2. Raven Press, New York, pp 195–210Google Scholar
  20. Ostrow S, van Echo D, Whitacre M, Ainser RS, Wiernik PH (1981) Physiologic response and toxicity in patients undergoing whole body hyperthermia for the treatment of cancer. Cancer Treat Rep 65: 323–325Google Scholar
  21. Parks LC, Minaberry D, Smith DP, Neely WA (1979) Treatment of far-advanced bronchogenic carcinoma by extracorporeally induced systemic hyperthermia. J Thorac Cardiovasc Surg 78: 883–892Google Scholar
  22. Pettigrew RT, Galt JM, Ludgate CM, Smith AN (1974a) Clinical effects of whole-body hyperthermia in advanced malignancy. Br Med J 4: 679–682Google Scholar
  23. Pettigrew RT, Galt JM, Ludgate CM, Horn DB, Smith AN (1974b) Circulatory and biochemical effects of whole body hyperthermia. Br J Surg 61: 727–730Google Scholar
  24. Pettigrew RT, Ludgate CM (1977) Whole body hyperthermia. A systemic treatment for disseminated cancer. In: Rossi-Fanelli A, Cavaliere R, Mondovi B, Moricca E (eds) Recent results in cancer research, vol 59. Springer Berlin Heidelberg New York, pp 153–170Google Scholar
  25. Pomp H (1978) Clinical application of hyperthermia in gynecological malignant tumors. In: Streffer C (ed) Proceedings of the Second International Symposium on Cancer Therapy by Hyperthermia and Radiation. Urban and Schwarzberg, Baltimore and Munich, pp 326–327Google Scholar
  26. Randall JE, Stacy RW (1956) Mechanical impedance of the dog's hind leg to pulsatile blood flow. Am J Physiol 187: 94–98Google Scholar
  27. Reinhold HS, van der Zee J, Faithfull NS, van Rhoon G, Wike-Hooley J (1982) Utilisation of the Pomp-Siemens Hyperthermia Cabin. In: Proceedings of the Third International Symposium on Cancer Therapy by Hyperthermia, Drugs and Radiation. Nat Cancer Inst Monograph 61: 361–365Google Scholar
  28. Rowell LB, Brengelmann GL, Murray JA (1969) Cardiovascular responses to sustained high skin temperature in resting man. J Appl Physiol 27: 673–680Google Scholar
  29. Versteegh PMR, van der Hoogen RHWM, Zwaveling A (1981) Systemic hyperthermia by the immersion bath method. Neth J Surg 33: 195–199Google Scholar

Copyright information

© Springer-Verlag 1984

Authors and Affiliations

  • N. S. Faithfull
    • 1
  • H. S. Reinhold
    • 2
  • A. P. van den Berg
    • 2
  • G. C. van Rhoon
    • 2
  • J. van der Zee
    • 2
  • J. L. Wike-Hooley
    • 2
  1. 1.Department of Anaesthesia, Division of Experimental AnaesthesiaErasmus UniversityDR RotterdamThe Netherlands
  2. 2.Department of Experimental RadiotherapyRotterdam Radiotherapeutic InstituteEA RotterdamThe Netherlands

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