Lees aub de waarschuwing voor dr. Robert Gorter en het Medisch Centrum Keulen. Dr. Robert Gorter is in opspraak geraakt in Duitsland en Egypte en ook wij distantiëren ons van dr. Robert Gorter. Klik hier of onder vragen voor uitvoerige uitleg waarom wij dr. Robert Gorter geen betrouwbare arts meer vinden.

22 mei 2005: Bron: Lancet. 1995 Mar 4;345(8949):540-3. en Int J Hyperthermia. 1996 Jan-Feb;12(1):3-20.

Hyperthermie aanvullend aan bestraling - radiotherapie bij patiënten met een recidief van melanomen en met uitgezaaide melanoom geeft significant meer 5 jaars overlevingen en significant betere controle over de ziekte. Al in 1996 publiceerden Deense onderzoekers in The Lancet deze studie, die gerandomiseerd uitgevoerd werd in meerdere ziekenhuizen. Waarom hiermee verder niets is gedaan weten we niet. Achtereenvolgens de twee abstracten over dezelfde studie uit zowel The Lancet en Int J Hyperthermia resp. uit 1995 en 1996.

Hyperthermia as an adjuvant to radiation therapy of recurrent or metastatic malignant melanoma. A multicentre randomized trial by the European Society for Hyperthermic Oncology.

Overgaard J, Gonzalez Gonzalez D, Hulshof MC, Arcangeli G, Dahl O, Mella O, Bentzen SM.
Danish Cancer Society, Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark.

The ESHO protocol 3-85 is a multicentre randomized trial investigating the value of hyperthermia as an adjuvant to radiotherapy in treatment of malignant melanoma. A total of 134 metastatic of recurrent malignant melanoma lesions in 70 patients were randomized to receive radiotherapy alone (3 fractions in 8 days) or each fraction followed by hyperthermia (aimed for 43 degrees C for 60 min). Radiation was given with high voltage photons or electrons. Tumours were stratified according to institution and size (above or below 4 cm) and randomly assigned to a total radiation dose of either 24 or 27 Gy to be given with or without hyperthermia. The endpoint was persistent complete response in the treated area. A number of 128 tumours in 68 patients were evaluable, with an observation time between 3 and 72 months. Sixty-five tumours were randomized to radiation alone and 63 to radiation + heat. Sixty received 24 Gy and 68 tumours received 27 Gy, respectively. Size was < or = 4 cm in 81 and > 4 cm in 47 tumours. Overall the 2-year actuarial local tumour control was 37%. Univariate analysis showed prognostic influence of hyperthermia (rad alone 28% versus rad + heat 46%, p = 0.008) and radiation dose (24 Gy 25% versus 27 Gy 56%, p = 0.02), but not of tumour size (small 42% versus large 29%, p = 0.21). A Cox multivariate regression analysis showed the most important prognostic parameters to be: hyperthermia (odds ratio: 1.73 (1.07-2.78), p = 0.02), tumour size (odds ratio: 0.91 (0.85-0.99), p = 0.05) and radiation dose (odds ratio: 1.17 (1.01-1.36), p = 0.05). Analysis of the heating quality showed a significant relationship between the extent of heating and local tumour response. Addition of heat did not significantly increase the acute or late radiation reactions. The overall 5-year survival rate of the patients was 19%, but 38% in patients if all known disease was controlled, compared to 8% in the patients with persistent active disease.

Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial

PMID: 8676005 [PubMed - indexed for MEDLINE]

Lancet. 1995 Mar 4;345(8949):540-3.

Comment in:
Lancet. 1995 Jun 24;345(8965):1635-6; author reply 1636-7.
Lancet. 1995 Jun 24;345(8965):1636; author reply 1636-7

. Randomised trial of hyperthermia as adjuvant to radiotherapy for recurrent or metastatic malignant melanoma. European Society for Hyperthermic Oncology.

Overgaard J, Gonzalez Gonzalez D, Hulshof MC, Arcangeli G, Dahl O, Mella O, Bentzen SM.
Danish Cancer Society Department of Experimental Clinical Oncology, Aarhus.

The value of hyperthermia as an adjuvant to radiotherapy in patients with malignant melanoma was studied in a European multicentre trial. 134 metastatic or recurrent lesions of malignant melanoma in 70 patients were randomly assigned to receive radiotherapy (three fractions of 8 Gy or 9 Gy in 8 days) alone or followed by hyperthermia (43 degrees C for 60 min). Overall, the 2-year actuarial local tumour control was 37 (SE 5)%. Univariate analysis showed a beneficial effect of hyperthermia (radiation alone 28% vs combined treatment 46%, p = 0.008) and radiation dose (24 Gy 25% vs 27 Gy 56%, p = 0.02), but no effect of tumour size (< or = 4 cm 42% vs > 4 cm 29%, p = 0.21). Cox multivariate regression analysis showed the most important prognostic variables to be hyperthermia (odds ratio for 2-year local control 1.73 [95% CI 1.07-2.78], p = 0.023), tumour size (0.91 [0.85-0.99], p = 0.05), and radiation dose (1.17 [1.01-1.36], p = 0.05). Addition of heat did not significantly increase acute or late radiation reactions. Heating was well tolerated, but because of difficulties with equipment only 14% of treatments achieved the protocol objective. The overall 5-year survival rate was 19%, but 38% of the patients for whom all known disease was controlled survived 5 years. Adjuvant hyperthermia significantly improved local tumour control when applied in association with radiation in treatment of malignant melanoma. Successful local treatment of patients with a single or a few metastatic malignant melanoma lesions has significant curative potential.

Publication Types:
Clinical Trial
Multicenter Study
Randomized Controlled Trial

PMID: 7776772 [PubMed - indexed for MEDLINE]

hyperthermie, melanomen


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