TY - JOUR
T1 - The role of hyperthermia in the treatment of locally advanced cervical cancer
T2 - a comprehensive review
AU - IJff, Marloes
AU - Crezee, Johannes
AU - Oei, Arlene L.
AU - Stalpers, Lukas J. A.
AU - Westerveld, Henrike
N1 - Funding Information: This work was funded by the Dutch Cancer Society KWF (grant 2015–7820). Publisher Copyright: © IGCS and ESGO 2022. Re-use permitted under CC BY. Published by BMJ.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Radiotherapy with cisplatin (chemoradiation) is the standard treatment for women with locally advanced cervical cancer. Radiotherapy with deep hyperthermia (thermoradiation) is a well established alternative, but is rarely offered as an alternative to chemoradiation, particularly for patients in whom cisplatin is contraindicated. The scope of this review is to provide an overview of the biological rationale of hyperthermia treatment delivery, including patient workflow, and the clinical effectiveness of hyperthermia as a radiosensitizer in the treatment of cervical cancer. Hyperthermia is especially effective in hypoxic and nutrient deprived areas of the tumor where radiotherapy is less effective. Its radiosensitizing effectiveness depends on the temperature level, duration of treatment, and the time interval between radiotherapy and hyperthermia. High quality hyperthermia treatment requires an experienced team, adequate online adaptive treatment planning, and is preferably performed using a phased array radiative locoregional hyperthermia device to achieve the optimal thermal dose effect. Hyperthermia is well tolerated and generally leads to only mild toxicity, such as patient discomfort. Patients in whom cisplatin is contraindicated should therefore be referred to a hyperthermia center for thermoradiation.
AB - Radiotherapy with cisplatin (chemoradiation) is the standard treatment for women with locally advanced cervical cancer. Radiotherapy with deep hyperthermia (thermoradiation) is a well established alternative, but is rarely offered as an alternative to chemoradiation, particularly for patients in whom cisplatin is contraindicated. The scope of this review is to provide an overview of the biological rationale of hyperthermia treatment delivery, including patient workflow, and the clinical effectiveness of hyperthermia as a radiosensitizer in the treatment of cervical cancer. Hyperthermia is especially effective in hypoxic and nutrient deprived areas of the tumor where radiotherapy is less effective. Its radiosensitizing effectiveness depends on the temperature level, duration of treatment, and the time interval between radiotherapy and hyperthermia. High quality hyperthermia treatment requires an experienced team, adequate online adaptive treatment planning, and is preferably performed using a phased array radiative locoregional hyperthermia device to achieve the optimal thermal dose effect. Hyperthermia is well tolerated and generally leads to only mild toxicity, such as patient discomfort. Patients in whom cisplatin is contraindicated should therefore be referred to a hyperthermia center for thermoradiation.
KW - cervical cancer
KW - radiotherapy
UR - http://www.scopus.com/inward/record.url?scp=85125965877&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/ijgc-2021-002473
DO - https://doi.org/10.1136/ijgc-2021-002473
M3 - Review article
C2 - 35046082
SN - 1048-891X
VL - 32
SP - 288
EP - 296
JO - International journal of gynecological cancer
JF - International journal of gynecological cancer
IS - 3
M1 - ijgc-2021-002473
ER -