Electro hyperthermie naast bestraling verbetert de 5-jaars overleving met 12 procent (79 vs 91 procent) bij patienten met neuskanker. Hyperthermie gaf ook 17 procent meer complete remissies

1 mei 2021: Bron: International journal of hyperthermie

Wanneer patiënten na een eerste diagnose van neuskanker naast een in intentie genezende bestraling - radiotherapie ook intravacitair (= in de neusgaten) electro hyperthermie krijgen dan hebben zij grotere kans op een complete remissie en verbetert de overall overleving op 5 jaar met 12 procent. Ook de complete remissies die werden bereikt waren in de hyperthermiegroep veel beter. Dit blijkt uit een fase III studie van augustus 2001 tot juli 2006 bij totaal 180 patiënten met een eerste diagnose van neuskanker.

Hier de resultaten:

Het percentage complete remissies (CR) in de twee groepen (Radio Therapie plus hyperthermie versus conventionele Radio Therapie was respectievelijk 95,6% en 81,1% (p = 0,003, χ2-test).
Complete remissie percentages voor T2- en T3-patiënten in de hyperthermiegroep waren respectievelijk 97,1% en 96,9%, terwijl ze in de conventionele Radio Therapie groep respectievelijk 79,5% en 76,7% waren. Het verschil tussen de twee groepen was statistisch significant (respectievelijk p = 0,03 en p = 0,024).
Het percentage lokale controle over 5 jaar was respectievelijk 91,1% en 78,9% voor de twee groepen (p = 0,022). Orale slijmtoxiciteit in beide groepen was vergelijkbaar.
Het percentage progressievrije tijd (PFS) na 5 jaar en het percentage overall overleving (OS) over 5 jaar voor de hyperthermiegroep versus de conventionele groep waren respectievelijk 72,7% versus 63,1% (p = 0,039) en 78,2% versus 70,3% (p = 0,14).

De conclusie van de onderzoekers is dan ook alleen maar positief over de hyperthermie:

Conventionele RT-behandeling gevolgd door intracavitaire hyperthermie werd goed verdragen door de patiënten met neuskanker. De toevoeging van hyperthermie verbeterde de lokale tumorcontrole en onze resultaten wezen op een positieve impact op progressievrije tijd (PFS) van patiënten met neuskanker.

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Abstract

Purpose: To compare the local tumour control, survival, and acute mucous toxicity of nasopharyngeal cancer (NPC) patients treated with conventional radiotherapy (RT) combined with intracavity hyperthermia versus conventional RT alone.

Methods and materials: Previously untreated NPC patients were assigned randomly into the conventional RT group and the hyperthermia group. In addition to curative RT, hyperthermia group patients received intracavity hyperthermia before or after RT; T90 was 42.5°–43°C for 50 min twice a week for 7 weeks.

Results: From August 2001 to July 2006, 180 eligible patients with NPC were enrolled in this study. The complete response (CR) rate in the two arms (RT plus hyperthermia versus conventional RT) was 95.6% and 81.1%, respectively (p = 0.003, χ2 test). CR rates for T2 and T3 patients in the hyperthermia group were 97.1% and 96.9%, respectively, while in the conventional RT group they were 79.5% and 76.7%, respectively. The difference between the two groups was statistically significant (p = 0.03 and p = 0.024, respectively). The 5-year local control rate was 91.1% and 78.9% for the two arms, respectively (p = 0.022). Oral mucous toxicity in both arms was comparable. The 5-year PFS and 5-year OS rate for the hyperthermia arm vs. the conventional arm were 72.7% versus 63.1% (p = 0.039) and 78.2% versus 70.3% (p = 0.14), respectively.

Conclusions: Conventional RT treatment followed by intracavity hyperthermia was well tolerated by the NPC patients. The addition of hyperthermia improved the local tumour control, and our results indicated a positive impact on PFS of NPC patients.

Acknowledgement

This work was sponsored by Zhejiang Provincial Program for the Cultivation of High-Level Innovative Health Talents.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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