Hyperthermie in combinatie met chemo en bestraling bij baarmoederkanker heeft groot effect - significant - op overlevingsduur aldus dubbelblinde gerandomiseerde Nederlandse studie

Zoals te lezen op de pagina andere alternatieven hyperthermie doet/deed Coby van der Zee in het Erasmus Medisch Centrum Rotterdam onderzoek naar hyperthermie als aanvulling op behandelingen bij met name baarmoederhalskanker. Haar dubbelblinde en gerandomiseerde studie, uitgevoerd in de periode 1990-1996 en gepubliceerd in de Lancet toonde een significant verschil in uitkomsten als bestraling gecombineerd wordt met hyperthermie. Onder andere alternatieven-hyperthermie nog meer significante resultaten over hyperthermie bij andere soorten kanker. Afgelopen week kregen we van verschillende kanten te horen dat artsen tegen patiënten zeggen dat hyperthermie niet bewezen is en geen zin zou hebben. Hieronder nog maar eens een paar artikelen uit Pubmed die anders bewijzen.

Anders in dit artikel staat een direct e-mailadres van Coby van der Zee of op pagina andere alternatieven hyperthermie nog meer adressen en telefoonnummers ook van Nederlandse en Duitse ziekenhuizen waar hyperthermie wordt uitgevoerd. Hier twee abstracts uit Pubmed gehaald waaronder de studie van Coby van der Zee e.a.:

Counterpoint: Test the value of hyperthermia in patients with carcinoma of the cervix being treated with concurrent chemotherapy and radiation.

Prosnitz L, Jones E.

Department of Radiation Oncology, Duke University Medical Center, Durham, NC 27710, USA.

Major advances in the treatment of locally advanced cervical carcinoma were reported in 1999-2000 in five studies from the Gynecologic Oncology Group, Radiation Therapy Oncology Group and Southwestern Oncology Group. Collectively these trials reported a decrease in the risk of recurrence or death from cervical cancer ranging from 30-50% with the use of concurrent chemoradiation, as compared with radiation alone. On the basis of these trials the National Cancer Institute in 1999 issued a clinical alert concluding 'Strong consideration should be given to the incorporation of concurrent cisplatin-based chemotherapy with radiation therapy in women who require radiation therapy for treatment of cervical cancer.' Concurrently with these publications there appeared the publication in the Lancet in 2000 of the Dutch Deep Hyperthermia Group trial of radiotherapy alone versus combined radiation and hyperthermia for locally advanced pelvic tumors including carcinoma of the cervix. This multi-center phase III trial demonstrated an approximate doubling of the three year survival from 27 to 51% for the addition of hyperthermia to radiotherapy in patients with locally advanced cervical carcinoma. Additional trials to test the value of hyperthermia in patients with cervical carcinoma treated with concurrent chemotherapy and radiation are imperative and take precedence over a trial to investigate the value of chemotherapy in patients treated with hyperthermia and radiation.

PMID: 11820463 [PubMed - indexed for MEDLINE]

Comparison of radiotherapy alone with radiotherapy plus hyperthermia in locally advanced pelvic tumours: a prospective, randomised, multicentre trial. Dutch Deep Hyperthermia Group.

van der Zee J, Gonzalez Gonzalez D, van Rhoon GC, van Dijk JD, van Putten WL, Hart AA.

Subdivision of Hyperthermia, Academic Medical Centre, Amsterdam, The Netherlands. zee@hyph.azr.nl

BACKGROUND: Local-control rates after radiotherapy for locally advanced tumours of the bladder, cervix, and rectum are disappointing. We investigated the effect of adding hyperthermia to standard radiotherapy.

METHODS: The study was a prospective, randomised, multicentre trial. 358 patients were enrolled from 1990 to 1996, in cancer centres in the Netherlands, who had bladder cancer stages T2, T3, or T4, NO, MO, cervical cancer stages IIB, IIIB, or IV, or rectal cancer stage M0-1 were assessed. Patients were randomly assigned radiotherapy (median total dose 65 Gy) alone (n=176) or radiotherapy plus hyperthermia (n=182). Our primary endpoints were complete response and duration of local control. We did the analysis by intention to treat.

FINDINGS: Complete-response rates were 39% after radiotherapy and 55% after radiotherapy plus hyperthermia (p<0.001). The duration of local control was significantly longer with radiotherapy plus hyperthermia than with radiotherapy alone (p=0.04). Treatment effect did not differ significantly by tumour site, but the addition of hyperthermia seemed to be most important for cervical cancer, for which the complete-response rate with radiotherapy plus hyperthermia was 83% compared with 57% after radiotherapy alone (p=0.003). 3-year overall survival was 27% in the radiotherapy group and 51% in the radiotherapy plus hyperthermia group. For bladder cancer, an initial difference in local control disappeared during follow-up.

INTERPRETATION: Hyperthermia in addition to standard radiotherapy may be especially useful in locally advanced cervical tumours. Studies of larger numbers of patients are needed for other pelvic tumour sites before practical recommendations can be made.

PMID: 10791373 [PubMed - indexed for MEDLINE]

baarmoederhalskanker, hyperthermie