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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

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.

References

1. Burris HA, 3rd, Moore MJ, Andersen J, et al. Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial. J Clin Oncol. 1997;15(6):2403–2413. [PubMed]
2. Riess H, Helm A, Niedergethmann M et al (2005) A randomised, prospective, multicenter, phase III trial of gemcitabine, 5-fluorouracil (5-FU), folinic acid vs. gemcitabine alone in patients with advanced pancreatic cancer. Proc. ASCO; Abstr No: 4009
3. Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364(19):1817–1825. doi: 10.1056/NEJMoa1011923. [PubMed] [Cross Ref]
4. Bakshandeh-Bath A, Stoltz AS, Homann N, Wagner T, Stölting S, Peters SO. Preclinical and clinical aspects of carboplatin and gemcitabine combined with whole-body hyperthermia for pancreatic adenocarcinoma. Anticancer Res. 2009;29(8):3069–3077. [PubMed]
5. Yamada S, Takai Y, Nemoto K, Ogawa Y, Kakuto Y, Hoshi A, Sakamoto K, Kimura Y, Kobari M. Intraoperative radiation therapy combined with hyperthermia against pancreatic carcinoma. Int J Oncol. 1992;1(7):795–798. [PubMed]
6. Kouloulias VE, Kouvaris JR, Nikita KS, Golematis BC, Uzunoglu NK, Mystakidou K, Papavasiliou C, Vlahos L. Intraoperative hyperthermia in conjunction with multi-schedule chemotherapy (pre-, intra- and post-operative), by-pass surgery, and post-operative radiotherapy for the management of unresectable pancreatic adenocarcinoma. Int J Hyperth. 2002;18(3):233–252. doi: 10.1080/02656730110108794. [PubMed] [Cross Ref]
7. Nakagawa A, Kamiyama Y, Matsui Y, Okuno M, Imamura A, Tu W, Nakagawa M, Kanemaki T, Takai S, Uetsuji S, Noro C, Kubo N, Nakase Y. Selective thermocoagulation of unresectable malignant tumors using radiofrequency [Article in Japanese] RiGan To Kagaku Ryoho. 1996;23(12):1651–1653. [PubMed]
8. Sugarbaker PH, Stuart OA, Bijelic L (2011) Intraperitoneal gemcitabine chemotherapy treatment for patients with resected pancreatic cancer: rationale and report of early data. Int J Surg Oncol 2011:185092. doi:10.1155/2011/185092 [PMC free article] [PubMed]
9. Esquivel J, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of peritoneal surface malignancies of colonic origin: a consensus statement. Ann Surg Oncol. 2006 [PubMed]
10. Mi D-H, Li Z, Yang K-H, Cao N, Lethaby A, Tian J-H, Santesso N, Ma B, Chen Y-L, Liu Y-L. Surgery combined with intraoperative hyperthermic intraperitoneal chemotherapy (IHIC) for gastric cancer: a systematic review and meta-analysis of randomised controlled trials. Int J Hyperth. 2013;29(2):156–167. doi: 10.3109/02656736.2013.768359. [PubMed] [Cross Ref]
11. Xiaoping L, Leizhen Z. Advances of high intensity focused ultrasound (HIFU) for pancreatic cancer. Int J Hyperth. 2013;29(7):678–682. doi: 10.3109/02656736.2013.837199. [PubMed] [Cross Ref]
12. Wang K, Chen L, Meng Z, Lin J, Zhou Z, Wang P, Chen Z. High intensity focused ultrasound treatment for patients with advanced pancreatic cancer: a preliminary dosimetric analysis. Int J Hyperth. 2012;28(7):645–652. doi: 10.3109/02656736.2012.713541. [PubMed] [Cross Ref]
13. Zhao H, Yang G, Wang D, Yu X, Zhang Y, Zhu J, Ji Y, Zhong B, Zhao W, Yang Z, Aziz F. Concurrent gemticatbine and high-intensity fucused ultrasound therapy in patients with locally advanced pancreatic cancer. Anticancer Drugs. 2010;21(4):447–452. doi: 10.1097/CAD.0b013e32833641a7. [PubMed] [Cross Ref]
14. Van der Zee J, Vujaskovic Z, Kondo M, Sugarhara T. Part I. Clinical hyperthermia. The Kadota Fund International Forum 2004 – clinical group consensus. Int J Hyperth. 2008;24(2):111–122. doi: 10.1080/02656730801895058. [PMC free article] [PubMed] [Cross Ref]
15. Kandel S, Kloeters C, Meyer H, Hein P, Hilbig A, Rogalla P. Whole-organ perfusion of the pancreas using dynamic volume CT in patients with primary pancreas carcinoma: acquisition technique, post-processing and initial results. Eur Radiol. 2009;19(11):2641–2646. doi: 10.1007/s00330-009-1453-z. [PubMed] [Cross Ref]
16. Fatehi D, van der Zee J, Notenboom A, van Rhoon GC. Comparison of intratumor and intraluminal temperatures during locoregional deep hyperthermia of pelvic tumors. Strahlenther Onkol. 2007;183:479–486. doi: 10.1007/s00066-007-1768-0. [PubMed] [Cross Ref]
17. Hahn GM, Braun J, Har-Kedar I. Thermochemotherapy: synergism between hyperthermia 42–43 degrees) and Adriamycin (of bleomycin) in mammalian cell inactivation. Proc Natl Acad Sci U S A. 1975;72:937–940. doi: 10.1073/pnas.72.3.937. [PMC free article] [PubMed] [Cross Ref]
18. Raoof M, Cisneros BT, Corr SJ, Palalon F, Curley SA, Koshkina NV. Tumor selective hyperthermia induced by short-wave capacitively-coupled RF electric-fields. PLoS One. 2013;4:8(7). [PMC free article] [PubMed]
19. Adachi S, Kokura S, Okayama T, Ishikawa T, Takagi T, Handa O, Naito Y, Yoshikawa T. Effect of hyperthermia combined with gemcitabine on apoptotic cell death in cultured human pancreatic cancer cell lines. Int J Hyperth. 2009;25(3):210–219. doi: 10.1080/02656730802657036. [PubMed] [Cross Ref]
20. Bull JM, Scott GL, Strebel FR, Nagle VL, Oliver D, Redwine M, Rowe RW, Ahn CW, Koch SM. Fever-range whole-body thermal therapy combined with cisplatin, gemcitabine, and daily interferon-alpha: a description of a phase I-II protocol. Int J Hyperth. 2008;24(8):649–662. doi: 10.1080/02656730802104740. [PubMed] [Cross Ref]
21. Apetoh L, Tesniere A, Ghiringhelli F, Kroemer G, Zitvogel L. Molecular interactions between dying tumor cells and the innate immune system determine the efficacy of conventional anticancer therapies. Cancer Res. 2008;68(11):4026–4030. doi: 10.1158/0008-5472.CAN-08-0427. [PubMed] [Cross Ref]
22. Horsman MR, Overgaard J. Hyperthermia: a potent enhancer of radiotherapy. Clin Oncol. 2007;19:418–426. doi: 10.1016/j.clon.2007.03.015. [PubMed] [Cross Ref]
23. Rubner Y, Wunderlich R, Rühle PF, Kulzer L, Werthmöller N, Frey B, Weiss EM, Keilholz L, Fietkau R, Gaip US. How does ionizing irradiation contribute to the induction of anti-tumor immunity? Front Oncol. 2012;2:75. doi: 10.3389/fonc.2012.00075. [PMC free article] [PubMed] [Cross Ref]
24. Hager ED, Migeod F, Koomagi R, Schrittwieser G, Krautgartner I. Multimodal complementary therapy for advanced pancreas carcinoma; translation of publication of Deutsche. Zeitschrift für Onkologie. 2006;38:100–107. doi: 10.1055/s-2006-952051. [Cross Ref]
25. Mueller-Huebenthal B (2010) Hyperthermia and gemcitabine for the treatment of advanced inoperable pancreatic cancer: a retrospective analysis of 25 cases. Presentation at the 6th binneal conference of Indian Association of Hyperthermia Oncology IAHOM; Jan 2010 Bangalore. (Updated data to be published 2014)
26. Sridhar PS (2012) Pain reduction in hyperthermia: 10 cases. Presentation at the 7th biennal conference of IAHOM, Febr. 2012 Indore
27. Lee GY, Qian WP, Wang L, Wang YA, Staley CA, Satpathy M, Nie S, Mao H, Yang L. Theranostic nanoparticles with controlled release of gemcitabine for targeted therapy and MRI of pancreatic cancer. ACS Nano. 2013;7(3):2078–2089. doi: 10.1021/nn3043463. [PMC free article] [PubMed] [Cross Ref]
28. Kim DH, Guo Y, Zhang Z, Procissi D, Nicolai J, Omary RA, Larson AC (2013) Temperature-sensitive magnetic drug carriers for concurrent gemcitabine chemohyperthermia. Adv Healthc Mater 3(5):714–24. doi:10.1002/adhm.201300209 [PMC free article] [PubMed]
29. McDaniel JR, Dewhirst MW, Chilkoti A. Actively targeting solid tumours with thermoresponsive drug delivery systems that respond to mild hyperthermia. Int J Hyperth. 2013;29(6):501–510. doi: 10.3109/02656736.2013.819999. [PubMed] [Cross Ref]
30. Zhang LP, Nie Q, Kang JB, Wang B, Cai CL, Li JG, Qi WJ. Efficacy of whole body gamma-knife radiotherapy combined with thermochemotherapy on locally advanced pancreatic cancer. Ai Zheng. 2008;27(11):1204–1207. [PubMed]
31. Maluta S, Schaffer M, Pioli F, Dall’oglio S, Pasetto S, Schaffer PM, Weber B, Giri MG. Regional hyperthermia combined with chemoradiotherapy in primary or recurrent locally advanced pancreatic cancer: an open-label comparative cohort trial. Strahlenther Onkol. 2011;187(10):619–625. doi: 10.1007/s00066-011-2226-6. [PubMed] [Cross Ref]
32. Ishikawa T, Kokura S, Sakamoto N, et al. Phase II trial of combined regional hyperthermia and gemcitabine for locally advanced or metastatic pancreatic cancer. Int J Hyperth. 2012;28(7):597–604. doi: 10.3109/02656736.2012.695428. [PubMed] [Cross Ref]
33. Tschoep-Lechner KE, Milani V, Berger F, Dieterle N, Abdel-Rahman S, Salat C, Issels RD. Gemcitabine and cisplatin combined with regional hyperthermia as second-line treatment in patients with gemcitabine-refractory advanced pancreatic cancer. Int J Hyperth. 2013;29(1):8–16. doi: 10.3109/02656736.2012.740764. [PubMed] [Cross Ref]

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

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