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30 maart 2016: Bron: Indian J Surg Oncol. 2015 Mar; 6(1): 75–81.

Hyperthermie bij alvleesklierkanker als aanvulling op chemo en/of bestraling of wellicht ook aanvullend op personalised medicine en immuuntherapie, wordt de laatste jaren veel onderzocht. Maar er is nog niet zo heel veel over gepubliceerd, al hoewel wij wel een aantal studies hebben geplaatst, zie gerelateerde artikelen en referentielijst hieronder.

Vorig jaar is er een review studie gepubliceerd die m.i. een mooi overzicht geeft van de huidige stand van zaken van hyperthermie bij alvleesklierkanker.

hyperthermie in AMC 1

Hyperthermie apparatuur in het AMC Amsterdam

Hier de studies die zijn opgenomen in de review studie

Table 1

Survey trials on pancreatic cancer treatments including hyperthermia

Trials on advanced pancreatic cancerCenterHyperthermia methodNo of patientsControl arm (%)Arm adding hperth. (%)Overall Survival (OS) benefit in arm including hyperthermiaBenefit OS odds ratioBenefit quality of life
Kouloulias et al. 2002 [6] Athens, Greece Intrasurgery surface heating 65 85 % 15 % 11 months (SE 2.4 months) p = 0.029 Better: p = 0.031
Yamada et al. 1992 [5] Sendai, Japan Intrasurgery surface heating 69 80 % 20 % 1 year OS:plus 6.9 % Only marginally better
2. year plus 4.2 %
Mi et al. 2013 [10] Meta-analysis for adv. gastric cancers Intraoperative HIPEC-thermoenhanced Chemotherapy 1906 in 16 rand. trials 1. year OS 2.99 (95 % Cl) 2.21 to 4.05; p < 0.00001 No higher risks; but increase incidences of abdominal pain
Hager et al. 2006 [24] Bad Bergzabern, Germany Non-invasive loco-reg. heating 46 100 % Median OS: 10.8 months QoL improvement & pain decrease (56 %)
1. year OS: 41 %
Zhang et al. (2008) [30] China Non-invasive loco-reg. heating 75 49 % 51 % 1. year OS plus 13 % No serious complicat.
2. year OS plus 50 %
Mueller-Huebenthal 2010 [25] Stuttgart, Germany Non-invasive loco-reg. heating 25 100 % Median OS 12.2 months Pain reduction observed
1. year OS: 51 %
Maluta et al. 2011 [31] Verona, Italy Non-invasive loco-reg. heating 60 50 % 50 % OS plus 4 months = +36 % p = 0.025 No increased toxicity
Ishikawa et al. 2012 [32] Multicentre Japan Non-invasive loco-reg. heating 18 100 % Median OS: 8 months; 1 year OS: 33 % No added toxicity except mild pain & skin rush
Tschoep-Lechner 2013 [33] Munich, Germany Non-invasive loco-reg. heating 23 100 % Median OS 12.9 months

Ik ga deze studie maar niet vertalen maar leest u zelf maar. Mocht u vragen hierover hebben stel ze gerust via redactie@kanker-actueel.nl

Maar zie hier dit studieprotocol voor hyperthermie bij alvleesklierkanker die eerder is stopgezet maar nu weer wel nieuwe patienten aanneemt: https://www.clinicaltrialsregister.eu/ctr-search/trial/2008-004802-14/DE

TRialoffice:

B.5 Contact point designated by the sponsor for further information on the trial
B.5.1 Name of organisation Coordinating center
B.5.2 Functional name of contact point Trial office
B.5.3 Address:
B.5.3.1 Street Address Marchioninistr. 15
B.5.3.2 Town/ city München
B.5.3.3 Post code 81377
B.5.3.4 Country Germany
B.5.4 Telephone number +498970957776
B.5.5 Fax number +498970954768
B.5.6 E-mail heat@med.uni-muenchen.de

Het volledige studierapport: Review: The Role of Hyperthermia in Treating Pancreatic Tumors 

is gratis in te zien met ook duidelijk omschrijving van de verschillende hyperthermie systemen die er gebruikt worden. Zie overigens daarvoor ook dit artikel:

https://kanker-actueel.nl/NL/hyperthermie-algemeen-een-vergelijking-en-beschrijving-van-verschillende-hyperthermie-systemen-zoals-die-in-nederland-en-ons-omringende-landen-worden-gebruikt.html

Hier het abstract van de reviewstudie met aan het eind een referentielijst:

Hyperthermia has the potential to significantly prolong life expectancies for pancreas cancer patients and this while maintaining a satisfying quality of life!

Indian J Surg Oncol. 2015 Mar; 6(1): 75–81.
Published online 2014 May 31. doi:  10.1007/s13193-014-0316-5
PMCID: PMC4412860

Review: The Role of Hyperthermia in Treating Pancreatic Tumors

Martin Roeschcorresponding author and Boris Mueller-Huebenthal
Author information ► Article notes ► Copyright and License information ►

Abstract

There is only marginal improvement in outcome of treating pancreatic cancer in the last two decades. Time to open up and have a fresh look at complementary adjuvant treatment options. Hyperthermia may be one such option. Hyperthermic intraperitoneal chemotherapy (HIPEC) predominantly as a intrasurgical procedure has already proved its justification. Non-invasive loco regional hyperthermia as complement to either chemo or radiation has not yet reached a comparable status of evidence. However the potential to eventually grow into such evidence is already clearly observable. This review presents the various methodologies available for hyperthermia, covers the initial clinical data that has been published and gives an outlook to what can be expected in the next 2–3 years to come. Hyperthermia has the potential to significantly prolong life expectancies and this while maintaining a satisfying quality of life!

Conclusion

Even though the currently existing data is heterogeneous and in parts methodologically criticizable, still it indicates a clear advantage of adjuvant hyperthermia in prolonging overall survival. Apart from incidences of abdominal pain in the HIPEC method, quality of life is even improved by adding hyperthermia.

Expectations are that the ongoing European prospective randomized phase III HEAT trial will yield valuable insight. Though this treatment option is still rather novel and the trials mentioned use different treatment schema, despite all the variations, they all show clear beneficial results indicating the potential that lies in hyperthermia as an additional adjuvant and palliative treatment option.

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Articles from Indian Journal of Surgical Oncology are provided here courtesy of Springer

koortstherapie, total body, dr. Issels, hyperthermie, alvleesklierkanker, gemcitabine, huidge stadn van zaken, wetenschappelijk bewijs, evidence based medicine


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