Deep Microwave Hyperthermia for Metastatic Tumors of the Liver

Abstract

A large number of human tumors have liver as a common site of metastatic disease.The prognosis of patients with this involvement is very poor. In a study of 390 patients with untreated metastatic liver disease the median survival was 75 days, with less than 7% surviving 1 year (Jaffe et al. 1968). In the same study, the proportion of the liver involved or the tumor volume was found to be an important factor influencing the duration of survival. In addition to the poor survival, patients with liver metastases frequently have poor quality of life due to distressing signs and symptoms, such as severe upper abdominal pain, nausea, and jaundice requiring therapeutic intervention. Unfortunately, therapy of hepatic metastases is not very effective. Hepatic artery ligation with or without infusion chemotherapy was found to be effective in selected patients. This treatment, however, has an unacceptable morbidity and mortality (Fortner et al. 1972). The use of an implanted pump for the administration of chemotherapeutic agents directly into the hepatic artery (HAI) has been investigated. In studies using 5-fluorodeoxyuridine (FUDR) and mitocycin C or FUDR and dichloromethotrexate via HAI, excellent response rate and good palliation were noted (Niederhuber et al. 1984; Shepard et al. 1985). This route of administration of chemotherapy (CT) may result in significant complications, including hepatitis in nearly half of the patients (Shepard et al. 1987). A combination of HAI with FUDR and liver irradiation was reported by Byfield et al. (1984). This combination was found to be effective for selected patients with liver metastases; however, there was again treatment toxicity, which resulted in one mortality in 28 patients so treated. Radiation therapy (RT) alone was reported in the early 1950s to be an effective and well-tolerated treatment for hepatic metastases (Phillips et al. 1954).