Oncothermia In Management Of Cancer

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Oncothermia, i. e. the loco-regional deep electro-hyperthermia system is a fast-developing supportive, complementary treatment method against different types of tumors. The principles are based on the classical method of hyperthermia, but the aim, beside the absolute increase in temperature, is especially the direct electric-field energy absorption in the extracellular liquid and destroying the membrane of the cancer cells. Oncothermia's effect is synergic to radiotherapy and to numerous chemotherapies. Furthermore, it leads to an increased immunogenicity and effectively reduces the pain of the patient.(1)

Oncothermia: how the method works and how it is used

A modulated electric field with a carrier frequency of 13.56 MHz is generated by two active electrodes. Since malignant tissue has higher conductivity than healthy human tissue, the electric field tends to flow predominantly through the malignant tumor tissue. The combination of deep layer heating and the electric field leads to stimulation of malignant tumor cells. This, in turn, triggers increased apoptotic activity in the tumor region and as a result, promotes cell death.Compared with classic Hyperthermia, which can result in burns, Oncothermia works at a significantly lower temperature. Oncothermia achieves a greater effect at just 38°C-42°C. Thanks to the selection at cellular level, the radiation only has an effect in the region of the tumor (2)

Oncothermia achieves a long lasting increase of the temperature in the extracellular liquid of the tumour tissue. Due to the constant energy-supply, a temperature gradient (temperature trap) between the extra- and intracellular electrolytes develops until the thermal equilibrium is reached at the end of the therapy. This (in absolute numbers very low) temperature difference acts on the likewise small distance through the cellular membrane (from extra- to intracellular) and that leads to a destabilizing thermal stress on the membrane of the tumour cells, leading those into apoptosis.(3)

Hyperthermia as a complementary methodThe most active regions of a tumor and regions far from blood supply are usually severely hypoxic and therefore radiation has reduced efficacy in these regions. The possible vasodilation caused by hyperthermia aids the synergy via the overall increased blood perfusion (oxygenation) creating considerable sensitization to ionizing radiation.

Chemotherapy drugs are delivered into the tumor through the blood circulation, therefore, it is most effective in the regions near arterioles. In this respect, chemotherapy is similar to radiation therapy in that it primarily targets regions of high blood perfusion due to the oxygen-rich conditions, then the region which is more distant from the fresh blood perfusion is less cooled, so treated effectively by hyperthermia, completing the treatment of the chemotherapy treated volume, the thermo-chemotherapy results in a better therapeutic effect and increases the target specificity as well as reducing systemic side effects.

Hyperthermia successes:

Summary of the results obtained in Japan by capacitive hyperthermia combined with radiotherapy.

Brain tumors treated by hyperthermia:

Lung and bronchus:Some successful clinical trials in combination with radiotherapy have shown the feasibility of the hyperthermia method for non-small cell lung cancer.Capacititive hyperthermia in combination with radiotherapy was also successful for locally advanced non-small lung cancer (5) the complete remission rate was 26% and 0% with and without hyperthermia, respectively.

Hepatocellular carcinoma and metastatic tumors of the liver.

References :(1)Keszler G, Csapo z, Spasokoutskaja T et al (2000) Hyperthermia increases the phoshorylation of deoxycytidine in the membrane phospholipid precursors and decrease its incorporation into DNA. AdvExper Med Biol 486:333-337.(2)Szasz, Andras; Szasz, Nora; Szasz, Oliver (2010-12-03). Oncothermia: Principles and Practices. Springer.ISBN 978-90-481-9497-1. http://books.google.com/books?id=Ek-2nEe1HpwC. Retrieved 31 July 2011.(3)Andocs G, Szasz O, Szasz A (2009). "Oncothermia treatment of cancer: from the laboratory to clinic".ElectromagnBiol Med 28 (2): 148–65. PMID 19811397. (4)Wismeth c.,Hirschmann B., Pascher C., Dudel C., Szaaz A.,Bogdahn U., Hau P.:Transcranial electro- hyperthermia combined with alkylating chemotherapy in patients with relapsing high-grade gliomas-phase I clinical results; Expanding the Frontiers of thermal Biology, medicine and Physics Annual Meeting of Society of Thermal Medicine, Tucsan, AZ. USA. 2009(5)Karasawa K, Muta N, Nakagawa K et al (1994) Thermoradiotherapy in the treatment of locally advanced non-small cell cancer. Int J radiatOncolBiolPhys 30(5): 1171-1177 (6)Dan A., Clinical experience of electro-hyperthermia for advanced lung tumors, ESHO Conference, Munich, june2003Ferrari VD, De Ponti S, Valcamonico F, Amoroso V, Grisanti S, ran goni G, Marpicati P, Vassalli L, Simoncini E, Marini G:Deep electro-hyperthermia (EHY) with or without thermo-active agents in patients with advanced hepatic cell carcinoma: phase ll study, Joumal of Clinical Oncology,25:18S,15168,2007