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Abdolmaleki S, Aliabadi A, Khaksar S. Unveiling the promising anticancer effect of copper-based compounds: a comprehensive review. J Cancer Res Clin Oncol 2024; 150:213. [PMID: 38662225 PMCID: PMC11045632 DOI: 10.1007/s00432-024-05641-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 02/03/2024] [Indexed: 04/26/2024]
Abstract
Copper is a necessary micronutrient for maintaining the well-being of the human body. The biological activity of organic ligands, especially their anticancer activity, is often enhanced when they coordinate with copper(I) and (II) ions. Copper and its compounds are capable of inducing tumor cell death through various mechanisms of action, including activation of apoptosis signaling pathways by reactive oxygen species (ROS), inhibition of angiogenesis, induction of cuproptosis, and paraptosis. Some of the copper complexes are currently being evaluated in clinical trials for their ability to map tumor hypoxia in various cancers, including locally advanced rectal cancer and bulky tumors. Several studies have shown that copper nanoparticles can be used as effective agents in chemodynamic therapy, phototherapy, hyperthermia, and immunotherapy. Despite the promising anticancer activity of copper-based compounds, their use in clinical trials is subject to certain limitations. Elevated copper concentrations may promote tumor growth, angiogenesis, and metastasis by affecting cellular processes.
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Affiliation(s)
- Sara Abdolmaleki
- Department of Pharmaceutical Chemistry, School of Science and Technology, The University of Georgia, Tbilisi, Georgia.
| | - Alireza Aliabadi
- Pharmaceutical Sciences Research Center, Health Institute, School of Pharmacy, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Samad Khaksar
- Department of Pharmaceutical Chemistry, School of Science and Technology, The University of Georgia, Tbilisi, Georgia.
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2
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Roohani S, Ehret F, Beck M, Veltsista DP, Nadobny J, Zschaeck S, Abdel-Rahman S, Eckert F, Flörcken A, Issels RD, Klöck S, Krempien R, Lindner LH, Notter M, Ott OJ, Pink D, Potkrajcic V, Reichardt P, Riesterer O, Spałek MJ, Stutz E, Wessalowski R, Zilli T, Zips D, Ghadjar P, Kaul D. Regional hyperthermia for soft tissue sarcoma - a survey on current practice, controversies and consensus among 12 European centers. Int J Hyperthermia 2024; 41:2342348. [PMID: 38653548 DOI: 10.1080/02656736.2024.2342348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024] Open
Abstract
PURPOSE To analyze the current practice of regional hyperthermia (RHT) for soft tissue sarcoma (STS) at 12 European centers to provide an overview, find consensuses and identify controversies necessary for future guidelines and clinical trials. METHODS In this cross-sectional survey study, a 27-item questionnaire assessing clinical subjects and procedural details on RHT for STS was distributed to 12 European cancer centers for RHT. RESULTS We have identified seven controversies and five consensus points. Of 12 centers, 6 offer both, RHT with chemotherapy (CTX) or with radiotherapy (RT). Two centers only offer RHT with CTX and four centers only offer RHT with RT. All 12 centers apply RHT for localized, high-risk STS of the extremities, trunk wall and retroperitoneum. However, eight centers also use RHT in metastatic STS, five in palliative STS, eight for superficial STS and six for low-grade STS. Pretherapeutic imaging for RHT treatment planning is used by 10 centers, 9 centers set 40-43 °C as the intratumoral target temperature, and all centers use skin detectors or probes in body orifices for thermometry. DISCUSSION There is disagreement regarding the integration of RHT in contemporary interdisciplinary care of STS patients. Many clinical controversies exist that require a standardized consensus guideline and innovative study ideas. At the same time, our data has shown that existing guidelines and decades of experience with the technique of RHT have mostly standardized procedural aspects. CONCLUSIONS The provided results may serve as a basis for future guidelines and inform future clinical trials for RHT in STS patients.
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Affiliation(s)
- Siyer Roohani
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité, Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité (Junior) Clinician Scientist Program, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), Partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Felix Ehret
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), Partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marcus Beck
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Danai P Veltsista
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jacek Nadobny
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sebastian Zschaeck
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité, Universitätsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité (Junior) Clinician Scientist Program, Berlin, Germany
| | - Sultan Abdel-Rahman
- Department of Medicine III, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Franziska Eckert
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
- Department of Radiation Oncology, AKH, Comprehensive Cancer Center Vienna, Medical University Vienna, Vienna, Austria
| | - Anne Flörcken
- Charité - Universitätsmedizin Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), Partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Hematology, Oncology and Tumor Immunology, Charité - Universitätsmedizin Berlin, corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Rolf D Issels
- Department of Medicine III, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Stephan Klöck
- Department of Radiation Oncology, Lindenhofspital Bern, Bern, Switzerland
| | - Robert Krempien
- Clinic for Radiotherapy, HELIOS Klinikum Berlin-Buch, Berlin, Germany
- MSB Medical School Berlin, Fakultät für Medizin, Berlin, Germany
| | - Lars H Lindner
- Department of Medicine III, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Markus Notter
- Department of Radiation Oncology, Lindenhofspital Bern, Bern, Switzerland
| | - Oliver J Ott
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | - Daniel Pink
- Department of Medical Oncology, Helios Klinikum Bad Saarow, Bad Saarow, Germany
- Cinic for Internal Medicine C - Haematology and Oncology, Stem Cell Transplantation and Palliative Care, University Medicine Greifswald, Greifswald, Germany
| | - Vlatko Potkrajcic
- Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany
| | - Peter Reichardt
- Department of Medical Oncology, Helios Klinikum Berlin-Buch, and Medical School Berlin, Berlin, Germany
| | - Oliver Riesterer
- Center for Radiation Oncology KSA-KSB, Kantonsspital Aarau, Aarau, Switzerland
| | - Mateusz Jacek Spałek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Department of Radiotherapy I, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Emanuel Stutz
- Department of Radiation Oncology, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland
| | - Rüdiger Wessalowski
- Department of Paediatric Haematology and Oncology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Thomas Zilli
- Department of Radiation Oncology, Oncology Institute of Southern Switzerland (IOSI), EOC, Bellinzona, Switzerland
- Facoltà di Scienze Biomediche, Università Della Svizzera Italiana (USI), Lugano, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Daniel Zips
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), Partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Pirus Ghadjar
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - David Kaul
- Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), Partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
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3
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Rupp L, Resag A, Potkrajcic V, Warm V, Wehner R, Jöhrens K, Bösmüller H, Eckert F, Schmitz M. Prognostic impact of the post-treatment T cell composition and spatial organization in soft tissue sarcoma patients treated with neoadjuvant hyperthermic radio(chemo)therapy. Front Immunol 2023; 14:1185197. [PMID: 37261361 PMCID: PMC10228739 DOI: 10.3389/fimmu.2023.1185197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/03/2023] [Indexed: 06/02/2023] Open
Abstract
Soft tissue sarcomas (STS) form a heterogeneous group of tumors sharing a mesenchymal origin. Despite good local control of the disease, the occurrence of distant metastases often limits survival of STS patients with localized, high-risk tumors of the extremities. Accumulating evidence suggests a central role for the tumor immune microenvironment in determining the clinical outcome and response to therapy. Thus, it has been reported that STS patients with a high immune signature and especially presence of B cells and tertiary lymphoid structures display improved overall survival and response to checkpoint inhibitor treatment. Here, we explored the effect of curative multimodal therapy on the T cell landscape of STS using multiplex immunohistochemistry. We analyzed the phenotype, frequency, and spatial distribution of STS-infiltrating CD8+ T cells by staining for CD8, 4-1BB, Granzyme B, Ki67, PD-1, and LAG-3 as well as CD3+ T helper cells using a panel consisting of CD3, T-bet, GATA3, RORγT, FoxP3, and Ki67. All patients received neoadjuvant radiotherapy plus locoregional hyperthermia with or without chemotherapy. While the treatment-naïve biopsy sample allows an analysis of baseline T cell infiltration levels, both intra- and peritumoral areas of the matched resected tissue were analyzed to assess composition and spatial distribution of the T cell compartment and its therapeutic modulation. Generally, post-treatment tissues displayed lower frequencies of CD3+ and CD8+ T cells. Association with clinical data revealed that higher post-treatment frequencies of peritumoral and intratumoral CD3+ T cells and intratumoral PD-1+ CD8+ T cells were significantly associated with improved disease-free survival (DFS), while these densities had no prognostic significance in the biopsy. Upon spatial analysis, a high ratio of intratumoral to peritumoral CD8+ T cells emerged as an independent prognostic marker for longer DFS. These results indicate that the STS T cell landscape is altered by multimodal therapy and may influence the clinical outcome of patients. An enhanced understanding of the STS immune architecture and its modulation by neoadjuvant therapy may pave the way towards novel treatment modalities and improve the long-term clinical outcome of STS patients.
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Affiliation(s)
- Luise Rupp
- Institute of Immunology, Faculty of Medicine Carl Gustav Carus, Technische Universität (TU) Dresden, Dresden, Germany
| | - Antonia Resag
- Institute of Immunology, Faculty of Medicine Carl Gustav Carus, Technische Universität (TU) Dresden, Dresden, Germany
| | - Vlatko Potkrajcic
- Department of Radiation Oncology, University Hospital Tuebingen, Tuebingen, Germany
| | - Verena Warm
- Institute of Pathology, University Hospital Tuebingen, Tuebingen, Germany
| | - Rebekka Wehner
- Institute of Immunology, Faculty of Medicine Carl Gustav Carus, Technische Universität (TU) Dresden, Dresden, Germany
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Korinna Jöhrens
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute of Pathology, University Hospital Carl Gustav Carus, Dresden, Germany
| | - Hans Bösmüller
- Institute of Pathology, University Hospital Tuebingen, Tuebingen, Germany
| | - Franziska Eckert
- Department of Radiation Oncology, University Hospital Tuebingen, Tuebingen, Germany
- Department of Radiation Oncology, Medical University of Vienna, Comprehensive Cancer Center Vienna, Vienna, Austria
| | - Marc Schmitz
- Institute of Immunology, Faculty of Medicine Carl Gustav Carus, Technische Universität (TU) Dresden, Dresden, Germany
- National Center for Tumor Diseases (NCT), Partner Site Dresden, Dresden, Germany
- German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany
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4
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Reis TO, Noronha SISR, Lima PMA, De Abreu ARR, Mesquita LBT, Ferreira FI, Silva FC, Chianca-Jr DA, De Menezes RC. Abdominal TRPV1 channel desensitization enhances stress-induced hyperthermia during social stress in rats. Auton Neurosci 2023; 246:103073. [PMID: 36736078 DOI: 10.1016/j.autneu.2023.103073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 12/22/2022] [Accepted: 01/24/2023] [Indexed: 01/28/2023]
Abstract
AIMS In rats, stress-induced hyperthermia caused by social interaction depends on brown adipose tissue (BAT) thermogenesis and peripheral vasoconstriction. However, the peripheral mechanisms responsible for regulating the level of hyperthermia during social stress are still unknown. The transient receptor potential vanilloid 1 (TRPV1) subfamily, expressed in sensory and visceral neurons, can serve as a thermoreceptor. Here, we tested the hypothesis that the abdominal TRPV1 is essential in regulating stress-induced hyperthermia during social stress. MAIN METHODS Male Wistar rats received an intraperitoneal injection of Resiniferatoxin (RTX) - an ultra-potent capsaicin analog, (i.e., to desensitize the TRPV1 channels) or vehicle. Seven days later, we evaluated the effects of abdominal TRPV1 channels desensitization on core body temperature (CBT), brown adipose tissue (BAT) temperature, tail skin temperature, and heart rate (HR) of rats subjected to a social stress protocol. KEY FINDINGS We found abdominal TRPV1 desensitization increased CBT and BAT temperature but did not change tail skin temperature and HR during rest. However, under social stress, we found that abdominal TRPV1 desensitization heightened the increase in CBT and BAT caused by stress. Also, it abolished the increase in tail skin temperature that occurs during and after social stress. TRPV1 desensitization also delayed the HR recovery after the exposure to the social stress. SIGNIFICANCE These results show that abdominal TRPV1 channels desensitization heightens stress-induced hyperthermia, causing heat dissipation during and after social stress, enabling optimal thermal control during social encounters.
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Affiliation(s)
- T O Reis
- Department of Biological Science, Laboratory of Cardiovascular Physiology, University of Ouro Preto, Ouro Preto, MG 35400-000, Brazil
| | - S I S R Noronha
- Department of Biological Science, Laboratory of Cardiovascular Physiology, University of Ouro Preto, Ouro Preto, MG 35400-000, Brazil
| | - P M A Lima
- Department of Biological Science, Laboratory of Cardiovascular Physiology, University of Ouro Preto, Ouro Preto, MG 35400-000, Brazil
| | - A R R De Abreu
- Department of Biological Science, Laboratory of Cardiovascular Physiology, University of Ouro Preto, Ouro Preto, MG 35400-000, Brazil
| | - L B T Mesquita
- Department of Biological Science, Laboratory of Cardiovascular Physiology, University of Ouro Preto, Ouro Preto, MG 35400-000, Brazil
| | - F I Ferreira
- Department of Biological Science, Laboratory of Cardiovascular Physiology, University of Ouro Preto, Ouro Preto, MG 35400-000, Brazil
| | - F C Silva
- Department of Biological Science, Laboratory of Cardiovascular Physiology, University of Ouro Preto, Ouro Preto, MG 35400-000, Brazil..
| | - D A Chianca-Jr
- Department of Biological Science, Laboratory of Cardiovascular Physiology, University of Ouro Preto, Ouro Preto, MG 35400-000, Brazil..
| | - R C De Menezes
- Department of Biological Science, Laboratory of Cardiovascular Physiology, University of Ouro Preto, Ouro Preto, MG 35400-000, Brazil..
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5
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Veltsista PD, Oberacker E, Ademaj A, Corradini S, Eckert F, Flörcken A, Kaul D, Lindner LH, Issels R, Ott OJ, Pink D, Potkrajcic V, Reichardt P, Roohani S, Spalek MJ, Riesterer O, Zips D, Ghadjar P. Hyperthermia in the treatment of high-risk soft tissue sarcomas: a systematic review. Int J Hyperthermia 2023; 40:2236337. [PMID: 37468132 DOI: 10.1080/02656736.2023.2236337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/07/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND The therapy of high-risk soft tissue sarcomas (STS) remains an interdisciplinary challenge. Regional hyperthermia (RHT) sparked interest as it has been shown to improve overall survival when added to perioperative chemotherapy (CTX). However, questions arise on how RHT should be optimally integrated into current multi-modal therapies. MATERIALS AND METHODS We performed a systematic literature review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies written in English and focused mainly on radiative RHT and superficial hyperthermia were evaluated and included. Studies including patients below the age of 18, with metastatic disease or review articles, were excluded. RESULTS We identified 15 clinical reports from 1990 until July 2022. Three articles combined RHT + CTX, and twelve focused on combined RHT + radiotherapy (RT) or neoadjuvant chemoradiotherapy (CRT). Most treatments were based on invasive thermometry, and less on magnetic resonance imaging (MRI)-based, noninvasive thermometry for STS of the extremities. Perioperative chemotherapy was used for the combination of RHT and CTX, mostly Ifosfamide-based. The effectiveness of RT appeared to be increased by RHT, especially with two RHT sessions/week. The trimodal simultaneous approach of neoadjuvant RHT and CRT was also feasible. No significant toxicity of RHT was reported. CONCLUSIONS The gathered data strengthen the beneficial role of RHT in the multimodal setting. Further expert consensus and clinical trials are required to determine the optimal integration of RHT in treating STS.
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Affiliation(s)
| | - Eva Oberacker
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Adela Ademaj
- Kantonsspital Aarau, Centre for Radiation Oncology KSA-KSB, Aarau, Switzerland
- Doctoral Clinical Science Program, University of Zürich, Zürich, Switzerland
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital Ludwig Maximilians Universität, München, Germany
| | - Franziska Eckert
- Department of Radiation Oncology, Eberhard Karls University Tuebingen, Tübingen, Germany
- Department of Radiation Oncology, Medical University of Vienna/AKH, Vienna, Austria
| | - Anne Flörcken
- Department of Hematology, Oncology and Tumor Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - David Kaul
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Berlin, Germany; German Cancer Consortium (DKTK), partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lars H Lindner
- Department of Medical Oncology, University Hospital Ludwig Maximilians Universität, München, Germany
| | - Rolf Issels
- Department of Medical Oncology, University Hospital Ludwig Maximilians Universität, München, Germany
| | - Oliver J Ott
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Daniel Pink
- Department of Medical Oncology, Helios Klinikum Bad Saarow, Bad Saarow, Germany
- Clinic for Internal Medicine C - Haematology and Oncology, Stem Cell Transplantation and Palliative Care, University Medicine Greifswald, Greifswald, Germany
| | - Vlatko Potkrajcic
- Department of Radiation Oncology, Eberhard Karls University Tuebingen, Tübingen, Germany
| | - Peter Reichardt
- Department of Medical Oncology, Helios Hospital Berlin-Buch, Berlin, Germany
| | - Siyer Roohani
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Berlin, Germany; German Cancer Consortium (DKTK), partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Mateusz Jacek Spalek
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Oliver Riesterer
- Kantonsspital Aarau, Centre for Radiation Oncology KSA-KSB, Aarau, Switzerland
| | - Daniel Zips
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, Berlin, Germany; German Cancer Consortium (DKTK), partner site Berlin, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Pirus Ghadjar
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany
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Feddersen TV, Poot DHJ, Paulides MM, Salim G, van Rhoon GC, Hernandez-Tamames JA. Multi-echo gradient echo pulse sequences: which is best for PRFS MR thermometry guided hyperthermia? Int J Hyperthermia 2023; 40:2184399. [PMID: 36907223 DOI: 10.1080/02656736.2023.2184399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
PURPOSE MR thermometry (MRT) enables noninvasive temperature monitoring during hyperthermia treatments. MRT is already clinically applied for hyperthermia treatments in the abdomen and extremities, and devices for the head are under development. In order to optimally exploit MRT in all anatomical regions, the best sequence setup and post-processing must be selected, and the accuracy needs to be demonstrated. METHODS MRT performance of the traditionally used double-echo gradient-echo sequence (DE-GRE, 2 echoes, 2D) was compared to multi-echo sequences: a 2D fast gradient-echo (ME-FGRE, 11 echoes) and a 3D fast gradient-echo sequence (3D-ME-FGRE, 11 echoes). The different methods were assessed on a 1.5 T MR scanner (GE Healthcare) using a phantom cooling down from 59 °C to 34 °C and unheated brains of 10 volunteers. In-plane motion of volunteers was compensated by rigid body image registration. For the ME sequences, the off-resonance frequency was calculated using a multi-peak fitting tool. To correct for B0 drift, the internal body fat was selected automatically using water/fat density maps. RESULTS The accuracy of the best performing 3D-ME-FGRE sequence was 0.20 °C in phantom (in the clinical temperature range) and 0.75 °C in volunteers, compared to DE-GRE values of 0.37 °C and 1.96 °C, respectively. CONCLUSION For hyperthermia applications, where accuracy is more important than resolution or scan-time, the 3D-ME-FGRE sequence is deemed the most promising candidate. Beyond its convincing MRT performance, the ME nature enables automatic selection of internal body fat for B0 drift correction, an important feature for clinical application.
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Affiliation(s)
- Theresa V Feddersen
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dirk H J Poot
- Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Margarethus M Paulides
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Electromagnetics for Care & Cure Research Lab, Center for Care and Cure Technologies Eindhoven (C3Te), Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Ghassan Salim
- Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Gerard C van Rhoon
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Applied Radiation and Isotopes, Reactor Institute Delft, Delft University of Technology, Delft, The Netherlands
| | - Juan A Hernandez-Tamames
- Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Imaging Physics, Applied Physics Faculty, Delft University of Technology, Delft, The Netherlands
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7
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VilasBoas-Ribeiro I, Franckena M, van Rhoon GC, Hernández-Tamames JA, Paulides MM. Using MRI to measure position and anatomy changes and assess their impact on the accuracy of hyperthermia treatment planning for cervical cancer. Int J Hyperthermia 2022; 40:2151648. [PMID: 36535922 DOI: 10.1080/02656736.2022.2151648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE We studied the differences between planning and treatment position, their impact on the accuracy of hyperthermia treatment planning (HTP) predictions, and the relevance of including true treatment anatomy and position in HTP based on magnetic resonance (MR) images. MATERIALS AND METHODS All volunteers were scanned with an MR-compatible hyperthermia device, including a filled waterbolus, to replicate the treatment setup. In the planning setup, the volunteers were scanned without the device to reproduce the imaging in the current HTP. First, we used rigid registration to investigate the patient position displacements between the planning and treatment setup. Second, we performed HTP for the planning anatomy at both positions and the treatment mimicking anatomy to study the effects of positioning and anatomy on the quality of the simulated hyperthermia treatment. Treatment quality was evaluated using SAR-based parameters. RESULTS We found an average displacement of 2 cm between planning and treatment positions. These displacements caused average absolute differences of ∼12% for TC25 and 10.4%-15.9% in THQ. Furthermore, we found that including the accurate treatment position and anatomy in treatment planning led to an improvement of 2% in TC25 and 4.6%-10.6% in THQ. CONCLUSIONS This study showed that precise patient position and anatomy are relevant since these affect the accuracy of HTP predictions. The major part of improved accuracy is related to implementing the correct position of the patient in the applicator. Hence, our study shows a clear incentive to accurately match the patient position in HTP with the actual treatment.
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Affiliation(s)
- Iva VilasBoas-Ribeiro
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Martine Franckena
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Gerard C van Rhoon
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Department of Applied Radiation and Isotopes, Reactor Institute Delft, Delft University of Technology, Delft, The Netherlands
| | - Juan A Hernández-Tamames
- Department of Radiology and Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Margarethus M Paulides
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.,Care and Cure research lab (EM-4C&C) of the Electromagnetics Group, Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
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Sebeke LC, Rademann P, Maul AC, Yeo SY, Castillo Gómez JD, Deenen DA, Schmidt P, de Jager B, Heemels WPMH, Grüll H, Heijman E. Visualization of thermal washout due to spatiotemporally heterogenous perfusion in the application of a model-based control algorithm for MR-HIFU mediated hyperthermia. Int J Hyperthermia 2021; 38:1174-1187. [PMID: 34374624 DOI: 10.1080/02656736.2021.1933616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE This article will report results from the in-vivo application of a previously published model-predictive control algorithm for MR-HIFU hyperthermia. The purpose of the investigation was to test the controller's in-vivo performance and behavior in the presence of heterogeneous perfusion. MATERIALS AND METHODS Hyperthermia at 42°C was induced and maintained for up to 30 min in a circular section of a thermometry slice in the biceps femoris of German landrace pigs (n=5) using a commercial MR-HIFU system and a recently developed MPC algorithm. The heating power allocation was correlated with heat sink maps and contrast-enhanced MRI images. The temporal change in perfusion was estimated based on the power required to maintain hyperthermia. RESULTS The controller performed well throughout the treatments with an absolute average tracking error of 0.27 ± 0.15 °C and an average difference of 1.25 ± 0.22 °C between T10 and T90. The MPC algorithm allocates additional heating power to sub-volumes with elevated heat sink effects, which are colocalized with blood vessels visible on contrast-enhanced MRI. The perfusion appeared to have increased by at least a factor of ∼1.86 on average. CONCLUSIONS The MPC controller generates temperature distributions with a narrow spectrum of voxel temperatures inside the target ROI despite the presence of spatiotemporally heterogeneous perfusion due to the rapid thermometry feedback available with MR-HIFU and the flexible allocation of heating power. The visualization of spatiotemporally heterogeneous perfusion presents new research opportunities for the investigation of stimulated perfusion in hypoxic tumor regions.
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Affiliation(s)
- Lukas Christian Sebeke
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, Cologne, Germany.,Eindhoven University of Technology, Department of Biomedical Engineering, Eindhoven, The Netherlands
| | - Pia Rademann
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Experimental Medicine, Cologne, Germany
| | - Alexandra Claudia Maul
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Experimental Medicine, Cologne, Germany
| | - Sin Yuin Yeo
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, Cologne, Germany.,Profound Medical GmbH, Hamburg, Germany
| | - Juan Daniel Castillo Gómez
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, Cologne, Germany
| | - Daniel A Deenen
- Eindhoven University of Technology, Department of Mechanical Engineering, Control Systems Technology, Eindhoven, The Netherlands
| | - Patrick Schmidt
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, Cologne, Germany
| | - Bram de Jager
- Eindhoven University of Technology, Department of Mechanical Engineering, Control Systems Technology, Eindhoven, The Netherlands
| | - W P M H Heemels
- Eindhoven University of Technology, Department of Mechanical Engineering, Control Systems Technology, Eindhoven, The Netherlands
| | - Holger Grüll
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, Cologne, Germany.,Eindhoven University of Technology, Department of Biomedical Engineering, Eindhoven, The Netherlands
| | - Edwin Heijman
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Institute of Diagnostic and Interventional Radiology, Cologne, Germany.,Philips Research, Eindhoven, The Netherlands
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VilasBoas-Ribeiro I, Curto S, van Rhoon GC, Franckena M, Paulides MM. MR Thermometry Accuracy and Prospective Imaging-Based Patient Selection in MR-Guided Hyperthermia Treatment for Locally Advanced Cervical Cancer. Cancers (Basel) 2021; 13:cancers13143503. [PMID: 34298716 PMCID: PMC8303939 DOI: 10.3390/cancers13143503] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Monitoring and controlling the temperature distribution combined with precise energy delivery are key components for hyperthermia treatment success. Magnetic resonance (MR) imaging is used clinically to monitor the temperature of the treated volume non-invasively. However, there are no comprehensive systematic studies on MR thermometry accuracy during deep pelvic hyperthermia, and the few investigational studies suffer from a high probability of bias due to lacking objective criteria for data inclusion. This study presents the first systematic analysis and defines an imaging-based criterion for prospective patient selection to standardize clinical MR thermometry accuracy assessments. Abstract The efficacy of a hyperthermia treatment depends on the delivery of well-controlled heating; hence, accurate temperature monitoring is essential for ensuring effective treatment. For deep pelvic hyperthermia, there are no comprehensive and systematic reports on MR thermometry. Moreover, data inclusion generally lacks objective selection criteria leading to a high probability of bias when comparing results. Herein, we studied whether imaging-based data inclusion predicts accuracy and could serve as a tool for prospective patient selection. The accuracy of the MR thermometry in patients with locally advanced cervical cancer was benchmarked against intraluminal temperature. We found that gastrointestinal air motion at the start of the treatment, quantified by the Jaccard similarity coefficient, was a good predictor for MR thermometry accuracy. The results for the group that was selected for low gastrointestinal air motion improved compared to the results for all patients by 50% (accuracy), 26% (precision), and 80% (bias). We found an average MR thermometry accuracy of 2.0 °C when all patients were considered and 1.0 °C for the selected group. These results serve as the basis for comprehensive benchmarking of novel technologies. The Jaccard similarity coefficient also has good potential to prospectively determine in which patients the MR thermometry will be valuable.
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Affiliation(s)
- Iva VilasBoas-Ribeiro
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.); (M.F.); (M.M.P.)
- Correspondence:
| | - Sergio Curto
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.); (M.F.); (M.M.P.)
| | - Gerard C. van Rhoon
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.); (M.F.); (M.M.P.)
- Department of Radiation Science and Technology, Faculty of Applied Sciences, Delft University of Technology, 2629 JB Delft, The Netherlands
| | - Martine Franckena
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.); (M.F.); (M.M.P.)
| | - Margarethus M. Paulides
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, 3015 GD Rotterdam, The Netherlands; (S.C.); (G.C.v.R.); (M.F.); (M.M.P.)
- Center for Care and Cure Technologies Eindhoven (C3Te), Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands
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10
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Crezee J, Franken NAP, Oei AL. Hyperthermia-Based Anti-Cancer Treatments. Cancers (Basel) 2021; 13:1240. [PMID: 33808948 PMCID: PMC7999567 DOI: 10.3390/cancers13061240] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/10/2021] [Indexed: 12/11/2022] Open
Abstract
Hyperthermia is an adjuvant local anti-cancer treatment using temperatures exceeding the physiologically optimal level, typically 40-43 °C for approximately one hour [...].
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Affiliation(s)
- Johannes Crezee
- Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands; (N.A.P.F.); (A.L.O.)
| | - Nicolaas A. P. Franken
- Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands; (N.A.P.F.); (A.L.O.)
- Laboratory for Experimental Oncology and Radiobiology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands
- Center for Experimental Molecular Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands
| | - Arlene L. Oei
- Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands; (N.A.P.F.); (A.L.O.)
- Laboratory for Experimental Oncology and Radiobiology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands
- Center for Experimental Molecular Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, The Netherlands
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11
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Clinical Performance and Future Potential of Magnetic Resonance Thermometry in Hyperthermia. Cancers (Basel) 2020; 13:cancers13010031. [PMID: 33374176 PMCID: PMC7794787 DOI: 10.3390/cancers13010031] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Hyperthermia is a treatment for cancer patients, which consists of heating the body to 43 °C. The temperature during treatment is usually measured by placing temperature probes intraluminal or invasively. The only clinically used option to measure temperature distributions non-invasively and in 3D is by MR thermometry (MRT). However, in order to be able to replace conventional temperature probes, MRT needs to become more reliable. In this review paper, we propose standardized performance thresholds for MRT, based on our experience of treating nearly 4000 patients. We then review the literature to assess to what extent these requirements are already being met in the clinic today and identify common problems. Lastly, using pre-clinical results in the literature, we assess where the biggest potential is to solve the problems identified. We hope that by standardizing MRT parameters as well as highlighting current and promising developments, progress in the field will be accelerated. Abstract Hyperthermia treatments in the clinic rely on accurate temperature measurements to guide treatments and evaluate clinical outcome. Currently, magnetic resonance thermometry (MRT) is the only clinical option to non-invasively measure 3D temperature distributions. In this review, we evaluate the status quo and emerging approaches in this evolving technology for replacing conventional dosimetry based on intraluminal or invasively placed probes. First, we define standardized MRT performance thresholds, aiming at facilitating transparency in this field when comparing MR temperature mapping performance for the various scenarios that hyperthermia is currently applied in the clinic. This is based upon our clinical experience of treating nearly 4000 patients with superficial and deep hyperthermia. Second, we perform a systematic literature review, assessing MRT performance in (I) clinical and (II) pre-clinical papers. From (I) we identify the current clinical status of MRT, including the problems faced and from (II) we extract promising new techniques with the potential to accelerate progress. From (I) we found that the basic requirements for MRT during hyperthermia in the clinic are largely met for regions without motion, for example extremities. In more challenging regions (abdomen and thorax), progress has been stagnating after the clinical introduction of MRT-guided hyperthermia over 20 years ago. One clear difficulty for advancement is that performance is not or not uniformly reported, but also that studies often omit important details regarding their approach. Motion was found to be the common main issue hindering accurate MRT. Based on (II), we reported and highlighted promising developments to tackle the issues resulting from motion (directly or indirectly), including new developments as well as optimization of already existing strategies. Combined, these may have the potential to facilitate improvement in MRT in the form of more stable and reliable measurements via better stability and accuracy.
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12
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Datta NR, Kok HP, Crezee H, Gaipl US, Bodis S. Integrating Loco-Regional Hyperthermia Into the Current Oncology Practice: SWOT and TOWS Analyses. Front Oncol 2020; 10:819. [PMID: 32596144 PMCID: PMC7303270 DOI: 10.3389/fonc.2020.00819] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/27/2020] [Indexed: 12/14/2022] Open
Abstract
Moderate hyperthermia at temperatures between 40 and 44°C is a multifaceted therapeutic modality. It is a potent radiosensitizer, interacts favorably with a host of chemotherapeutic agents, and, in combination with radiotherapy, enforces immunomodulation akin to “in situ tumor vaccination.” By sensitizing hypoxic tumor cells and inhibiting repair of radiotherapy-induced DNA damage, the properties of hyperthermia delivered together with photons might provide a tumor-selective therapeutic advantage analogous to high linear energy transfer (LET) neutrons, but with less normal tissue toxicity. Furthermore, the high LET attributes of hyperthermia thermoradiobiologically are likely to enhance low LET protons; thus, proton thermoradiotherapy would mimic 12C ion therapy. Hyperthermia with radiotherapy and/or chemotherapy substantially improves therapeutic outcomes without enhancing normal tissue morbidities, yielding level I evidence reported in several randomized clinical trials, systematic reviews, and meta-analyses for various tumor sites. Technological advancements in hyperthermia delivery, advancements in hyperthermia treatment planning, online invasive and non-invasive MR-guided thermometry, and adherence to quality assurance guidelines have ensured safe and effective delivery of hyperthermia to the target region. Novel biological modeling permits integration of hyperthermia and radiotherapy treatment plans. Further, hyperthermia along with immune checkpoint inhibitors and DNA damage repair inhibitors could further augment the therapeutic efficacy resulting in synthetic lethality. Additionally, hyperthermia induced by magnetic nanoparticles coupled to selective payloads, namely, tumor-specific radiotheranostics (for both tumor imaging and radionuclide therapy), chemotherapeutic drugs, immunotherapeutic agents, and gene silencing, could provide a comprehensive tumor-specific theranostic modality akin to “magic (nano)bullets.” To get a realistic overview of the strength (S), weakness (W), opportunities (O), and threats (T) of hyperthermia, a SWOT analysis has been undertaken. Additionally, a TOWS analysis categorizes future strategies to facilitate further integration of hyperthermia with the current treatment modalities. These could gainfully accomplish a safe, versatile, and cost-effective enhancement of the existing therapeutic armamentarium to improve outcomes in clinical oncology.
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Affiliation(s)
- Niloy R Datta
- Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, Aarau, Switzerland
| | - H Petra Kok
- Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Hans Crezee
- Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Udo S Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Stephan Bodis
- Centre for Radiation Oncology KSA-KSB, Kantonsspital Aarau, Aarau, Switzerland
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