Thermobiology and Clinical Application of Interstitial and Superficial Hyperthermia in Two Groups of Patients: a New Approach for Treating Malignant Tumors

ABSTRACT Two groups of patients were treated with combined modality radiation and hyperthermia at the Strahlentherapeutische Klinik, Universitit Erlangen-Nurnberg, Federal Republic of Germany, from October 1987 to July 1988. The first group of 8 patients (4 cases of carcinoma of-the floor of the mouth, 3 cases of tongue carcinoma, 1 case of Ewing sarcoma) was treated with combination radiation and interstitial hyperthermia. 7 cases have complete remission (87.5%), whereas 1 case has partial remission (12.5%). The second group of 6 patients (5 breast cancer recurrences in the chest wall and supraclavicular region, 1 case with cancer of the parotid gland) were treated with combined radiation of electron beam 12 Mev by Siemens Mevatron 20 and superficial hyperthermia using Lund Buehler hyperthermia system 4010, 915 MHZ/20 W, once a week. 4 cases have complete remission (66.6%) and two cases have partial remission (33.3%). As a background of hyperthermia we also describe the principles of thermobiology, heat interaction with irradiation, physiologic mechanisms, and effects of hypertherrnia on microvasculature of tumors as well, as basic principles of physics and instrumentation of hyperthermia. key words: cancer-hyperthermia-radiation therapy-thermobiology-thermometr

Radiotherapy in langerhans cell histiocytosis - a rare indication in a rare disease

Introduction: Langerhans Cell Histiocytosis (LCH) represents a rare benign disorder, previously designated as “Histiocytosis X”, “Type II Histiocytosis” or “Langerhans Cell Granulomatosis”. Clinical presentation includes osteolysis, ulcerations of skin and soft tissues but also involvement of the CNS is described. Because treatment concepts are not well defined the German Cooperative Group on Radiotherapy for Benign Diseases performed a retrospective analysis. Methods and material: Eight closely cooperating centres collected patients’ data of the past 45 years. As study endpoints disease free survival, recurrent disease, death and therapy related side effects were defined. Results: A total of 80 patients with histologically proven LCH were irradiated within the past 45 years. According to the LCH classification of Greenberger et al. 37 patients had stage Ia, 21 patients stage Ib, 13 patients stage II and 9 patients stage IIIb and the median age was 29 years. The median Follow up was 54 months (range 9–134 months). A total of 39 patients had a surgical intervention and 23 patients a chemotherapy regimen. Radiation treatment was carried out with a median total dose of 15 Gy (range 3–50.4 Gy). The median single fraction was 2 Gy (range 1.8-3 Gy). Overall, 77% patients achieved a complete remission and 12.5% achieved a partial remission. The long-term control rate reached 80%. Within an actuarial overall 5-year survival of 90% no radiogenic side and late effects ≥EORTC/RTOG II° were observed. Conclusion: In the present study a large collective of irradiated patients was analysed. Radiotherapy (RT) is a very effective and safe treatment option and even low RT doses show sufficient local control.<br