The outcomes following standard of care in locally advanced head and neck cancer have ceased to show any further improvement in survival. Chemo-radiation is now the standard of care in the management of these cancers. Hyperthermia as an adjuvant to radiation alone or chemo-radiation alone or chemo-radiation is an interesting prospects to further improve the outcomes. Hyperthermia has the potential to act synergistically with radiation and chemotherapy. This is a report of the practice of hyperthermia in a single institution since 2000.
Materials and Methods
A retrospective analysis of patients of head and neck cancer treated at Nanavati Hospital were analysed for immediate response and survival. The patient files were retrieved and data was entered in electronic analysed. Out of 603 patients in between 2000 to 2013 only 515 could be analysed. Patients received hyperthermia with radiation and chemoradiaiton with hyperthermia. Radiation to a dose of 66.70 Gy was delivered with conventional fractionation on telecobalt machine and later on 6MV linear accelerator hyperthermia was delivered with modified Thermatron 8.1 operating at 8.2 MHZ and energy varing from 400 to 800 Kwatts. Invasive thermometry with thermister protons was performed in a few selected patients.
HT+RT was delivered in 320 patients while 195 was delivered in CT+RT+HT. The initial complete response in HT+RT was 87.1% and CT+RT+HT was 92.5% only, grade III thermal burn was seen. No additional toxicity was seen due to hyperthermia.
Hyperthermia has the potential to act synergistically with radiation alone or chemo-radiation. It is one of the best inhibiting repain of a single or double breaks following radiation. Heat can improve influx of drugs, while drugs like cisplatinum, act synergistically with heat. There is a considerable evidence for the use of hyperthermia in oncology.