Confirmation of thermal dose as a predictor of local control in cervical carcinoma patients treated with state-of-the-art radiation therapy and hyperthermia. (November 2019)

• Record Type: Journal Article
• Authors: Kroesen, Michiel; Mulder, Hendrik T.; van Holthe, Jeanette M.L.; Aangeenbrug, Aleida A.; Mens, Jan Willem M.; van Doorn, Helena C.; Paulides, Margarethus M.; Oomen-de Hoop, Esther; Vernhout, Rene M.; Lutgens, Ludy C.; van Rhoon, Gerard C.; Franckena, Martine
• Is Part Of: Radiotherapy and oncology. Volume 140(2019)
• Page Start: 150
• Page End: 158
• Publication Date: 2019-11
• Subjects: Hyperthermia -- Cervical cancer -- Treatment outcome -- Thermal dose -- Trise -- CEM43T90 -- Image guided brachytherapy; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2019.06.021
• Languages: English
• ISSNs: 0167-8140

Abstract

Highlights: Significant local control improvement in cervical cancer patients due to hyperthermia was validated in a recent patient cohort. Hyperthermia is effective in combination with modern radiotherapy techniques, such as image guided brachytherapy. Abstract: Background: Addition of deep hyperthermia results in improved local control (LC) and overall survival (OS) compared to radiotherapy alone in patients with cervical carcinoma. Previously, we showed that the thermal dose of hyperthermia significantly correlates with LC and disease specific survival (DSS). Over the last decade, new radiation techniques were introduced resulting in improved LC. Aim: To validate the effect of thermal dose in a more recent cohort of patients treated with modern radiotherapy techniques, including image guided brachytherapy (IGBT). Methods: We analyzed primary cervical carcinoma patients treated with a combination of radiotherapy and deep hyperthermia between 2005 and 2016 at our institute. Data on patient, tumor and treatment were collected including the thermal dose parameters TRISE and CEM43T90. Follow-up data on LC, disease free survival, DSS, OS as well as late toxicity data were collected. Data were analyzed using the Cox proportional hazard and Kaplan–Meier analyses. Results: 227 patients were included. In multivariate analysis, histology, FIGO stage, lymphadenopathy, TRISE, CEM43T90 and IGBT had a significant effect on LC. In the patients treated with IGBT, the thermal dose parameter TRISE remained to have a significant effect on LC in univariate analysis. Conclusions: The positive association between thermal dose and clinical outcome is replicated in an independent, recent cohort of cervical carcinoma patients. Importantly, in patients receiving IGBT, the effect of thermal dose on clinical outcome is still observed.