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 2009: Bron: 1: Eur J Cancer. 2009 Apr 8. [Epub ahead of print]Click here to read Links
 
Dit is een update van dezelfde studie van hyperthermie samen met bestraling bij baarmoederhalskanker die oinder dit nieuwe abstract staat en dat we vorig jaar mei plaatsten. Waarbij 77% remisseis werden bereikt en 47,5 % haalde alsnog de 5-jaarsoverleving. Let wel het gaat hier om hyperthermie apparatuur die geleverd wordt door BSD, die het alleen recht heeft in Nederland om hyperthermie apparatuur te leveren en die maar bij een beperkt aantal kankervormen kan worden gebruikt omdat bj deze gebruikte apparatuur het risico op verbranden (graad 2 en 3) altijd aanwezig is. Andere hyperthermie apparatuur van bv. Oncotherm , nu Celcius 42 geheten, werkt anders (zie o.a. de video verhalen) en geeft geen verbrandingsverschijnselen en kan bij elke vorm van kanker worden gebruikt.
 
Hier het nieuwste abstract zo goed als letterlijk vertaald:
 
Hyperthermie dosis-effect relatie in 420 patiënten met baarmoederhalskanker behandeld met gecombineerde radiotherapie en hyperthermie .
 
Toevoeging van hyperthermie aan standaard radiotherapie (RT + HT) verbetert behandelingsuitkomsten voor patiënten met lokaal gevorderde baarmoederhalskanker (LACC). We hebben het effect onderzocht van verschillende doses hyperthermie op de effectiviteit voor patiënten met LACC behandeld met RT + HT. Wij verzamelden behandelings- en resultaatgegevens van 420 patiënten met LACC die zijn behandeld met hyperthermie op ons instituut van 1990 tot 2005.
Univariabele en multivariabele analyses werden uitgevoerd op respons - aanslaan, lokale controle, ziekte-specifieke overleving en de toxiciteit - bijwerkingen voor deze patiënten om te zoeken naar een thermische dosis-respons relatie.
 
Naast de algemeen geïdentificeerde prognostische factoren in LACC zoals tumor stadium, performance status, radiotherapie dosis en tumor grootte, bleek uit de thermische parameters dat zowel de temperatuur en de duur van de verwarming naar voren komen als belangrijke voorspellers van de verschillende eindpunten. De meer gangbare CEM43T90 (cumulatief gelijkwaardige minutenduur - T90 boven 43 graden C) is minder invloedrijk dan TRISE (gebaseerd op de gemiddelde stijging T50 en de duur van de verwarming, aangepast naar de geplande duur van de behandeling). CEM43T90 en TRISE gemeten intraluminally correleren significant en onafhankelijk met tumor controle en overleving. Deze bevindingen stimuleren verdere technologische ontwikkeling en verbetering van diepte hyperthermie, want het ljikt er sterk op dat het wellicht de moeite waard is om de thermische dosis voor LACC, hetzij door de behandeling te optimaliseren of door verlenging van de behandelingstijd. Deze resultaten bevestigen ook de gunstige effecten van hyperthermie zoals blijkt uit onze eerdere gerandomiseerde trial, en rechtvaardigen de toepassing van radiotherapie en hyperthermie als behandelingskeuze voor patiënten met vergevorderde baarmoederhalskanker.

Hyperthermia dose-effect relationship in 420 patients with cervical cancer treated with combined radiotherapy and hyperthermia.

Erasmus Medical Center Rotterdam, Department of Radiation Oncology, P.O. Box 5201, 3008 AE, Rotterdam, The Netherlands.

Adding hyperthermia to standard radiotherapy (RT+HT) improves treatment outcome for patients with locally advanced cervical cancer (LACC). We investigated the effect of hyperthermia dose on treatment outcome for patients with LACC treated with RT+HT. We collected treatment and outcome data of 420 patients with LACC treated with hyperthermia at our institute from 1990 to 2005. Univariate and multivariate analyses were performed on response rate, local control, disease-specific survival and toxicity for these patients to search for a thermal dose response relationship. Besides commonly identified prognostic factors in LACC like tumour stage, performance status, radiotherapy dose and tumour size, thermal parameters involving both temperature and duration of heating emerged as significant predictors of the various end-points. The more commonly used CEM43T90 (cumulative equivalent minutes of T90 above 43 degrees C) was less influential than TRISE (based on the average T50 increase and the duration of heating, normalised to the scheduled duration of treatment). CEM43T90 and TRISE measured intraluminally correlate significantly and independently with tumour control and survival. These findings stimulate further technological development and improvement of deep hyperthermia, as they strongly suggest that it might be worthwhile to increase the thermal dose for LACC, either by treatment optimisation or by prolonging the treatment time. These results also confirm the beneficial effects from hyperthermia as demonstrated in our earlier randomised trial, and justify applying radiotherapy and hyperthermia as treatment of choice for patients with advanced cervical cancer.

PMID: 19361982 [PubMed - as supplied by publisher]

 

 

11 december 2008: International Journal of Radiation Oncology Biology Physics (IJROBP, DOI: 10.1016/j.ijrobp.2008.03.072 [

Hyperthermie en bestraling bij baarmoederhalskanker stadium III en IV zorgt voor 77% complete remissies en 47% 5 jaars overlevingen. Dit blijkt uit een nadere analyse van de patienten die niet aan de gerandomiseerde studie meededen opgezet en uitgevoerd door o.a. Het Erasmus Medisch Centrum Rotterdam bij o.a. Coby van der Zee. Hier het abstract van de studie. Zie ook andere abstract van de gerandomiseerde fase III studie op deze pagina

Radiotherapy and Hyperthermia for Treatment of Primary Locally Advanced Cervix Cancer: Results in 378 Patients.

 

 

 

Department of Radiation Oncology, Erasmus Medical Center, Rotterdam, The Netherlands.

PURPOSE: To report response rate, pelvic tumor control, survival, and late toxicity after treatment with combined radiotherapy and hyperthermia (RHT) for patients with locally advanced cervical carcinoma (LACC) and compare the results with other published series.

METHODS AND MATERIALS: From 1996 to 2005, a total of 378 patients with LACC (International Federation of Gynecology and Obstetrics Stage IB2-IVA) were treated with RHT. External beam radiotherapy (RT) was applied to 46-50.4 Gy and combined with brachytherapy. The hyperthermia (HT) was prescribed once weekly. Primary end points were complete response (CR) and local control. Secondary end points were overall survival, disease-specific survival, and late toxicity. Patient, tumor, and treatment characteristics predictive for the end points were identified in univariate and multivariate analyses.

RESULTS: Overall, a CR was achieved in 77% of patients. At 5 years, local control, disease-specific survival, and incidence of late toxicity Common Terminology Criteria for Adverse Events Grade 3 or higher were 53%, 47%, and 12%, respectively. In multivariate analysis, number of HT treatments emerged as a predictor of outcome in addition to commonly identified prognostic factors.

CONCLUSIONS: The CR, local control, and survival rates are similar to previously observed results of RHT in the randomized Dutch Deep Hyperthermia Trial. Reported treatment results for currently applied combined treatment modalities (i.e., RT with chemotherapy and/or HT) do not permit definite conclusions about which combination is superior. The present results confirm previously shown beneficial effects from adding HT to RT and justify the application of RHT as first-line treatment in patients with LACC as an alternative to chemoradiation.

PMID: 18990505 [PubMed - as supplied by publisher]

ASTRO’s Official Journal Publishes Data from Treatment of 378 Additional Patients, with Results Similar to Prior Landmark Study of Hyperthermia Therapy and Cervical Cancer

SALT LAKE CITY, December 10, 2008—BSD Medical Corporation (NASDAQ:BSDM) today announced that a report entitled, “Radiotherapy and Hyperthermia for Treatment of Primary Locally Advanced Cervix Cancer: Results in 378 Patients” has been published in the International Journal of Radiation Oncology Biology Physics (IJROBP, DOI: 10.1016/j.ijrobp.2008.03.072 [Epub ahead of print]). The report lends major support to the results from a landmark study on the use of hyperthermia therapy as a companion to radiation for treating advanced cervical cancer patients in that the results from this large follow-up population of patients were similar to those observed in the original study. The publication (IJROBP), commonly known as the “Red Journal,” is the official journal of the American Society for Therapeutic Radiology and Oncology (ASTRO), the world’s leading professional organization devoted to radiation oncology.

The study reported the results from 378 locally advanced cervical carcinoma patients who were treated with combined radiation and hyperthermia therapy delivered using the BSD-2000 by BSD Medical Corporation. (The BSD-2000 is an investigational device in the US that is limited to investigational use.) The patients were in the advanced stages of cervical cancer. Almost half the patients (49%) had Stage IIIB/IVA tumors, 30% had evidence of positive lymph nodes on CT scan and 93% had a tumor larger than 6 cm measured on CT scan, which are very negative prognostic indicators for outcome. In spite of the advanced nature of their disease, the researchers reported that 77% of the patients treated had a complete response rate (disappearance of the tumor) (95% confidence interval , 73–81). The five year follow-up data demonstrated a pelvic tumor control rate of 53% (95% CI, 48–59) and a disease-specific survival rate of 47% (95% CI, 41–53). The overall survival rate was 40% at 5 years (95% CI, 34–46).

The researchers compared the current study results to the study results of the randomized Phase III cancer study comparing the effectiveness of hyperthermia and radiation to radiation treatments alone, which was published in The Lancet in April 2000, designated as the Dutch National Deep Hyperthermia study (DDH) addressing pelvic tumors. This original study also included patients with advanced cervical cancer who had negative prognostic indicators for response. The results from the current 378 patient study demonstrated efficacy comparable to the original DDH study data with no evidence of safety issues beyond those expected with RT alone. The complete response rate was 77% in the post-DDH study as compared to 83% in the author’s analysis of the original DDH study. Similarly, five-year disease specific survival was 47% with the new data versus 46% in the original study. One year after treatment, the incidence of grade ≥ 3 late toxicity was 6%, which is the same incidence reported for RT alone.

Radiation Treatments with and without Hyperthermia Therapy

The randomized phase III Dutch Deep Hyperthermia Study was first published showing 3-year data and comparing results for patients treated with radiation plus hyperthermia therapy to those treated with radiation alone. For cervical cancer patients, the author’s analysis data showed a complete-response rate of 83% for patients receiving both hyperthermia and radiation therapy as compared to 57% for those receiving radiation alone (p=.003), noting also that “the improved local-control rates were not accompanied by increased toxic effects from radiation.” Survival follow-up data showed a 51% survival rate for patients who received radiation plus hyperthermia therapy, as compared to 27% of those who received radiation therapy alone (LANCET vol. 355, pp. 1119-1125).

Study Background

The study was coordinated by the Departments of Radiation Oncology and Trials and Statistics, Erasmus Medical Center, Rotterdam, The Netherlands. Eramus Medical Center is renowned internationally for its expertise in the fields of clinical sciences, health sciences and biomedical sciences and is the largest center in Europe for knowledge development, training and care in the field of sickness and health.
 

 

 


Plaats een reactie ...

Reageer op "Baarmoederhalskanker: .Hogere dosering van hyperthermie intensiteit en behandelingstijd vergroten effect van hyperthermie naast bestraling van gevorderde baarmoederhalskanker."


Gerelateerde artikelen
 

Gerelateerde artikelen

Baarmoederkanker: Hyperthermie >> Baarmoederhalskanker: Hyperthermie >> Baarmoederkanker en hyperthermie: >> Baarmoederhalskanker: Hyperthermie >> Baarmoederhalskanker:: Hyperthermie >> Baarmoederhalskanker: .Hogere >> Baarmoederhalskanker: Hyperthermie >> Baarmoederkanker: Hyperthermie >>