Summary:
Hyperthermia (HT) in cancer management refers to the external application of heat to raise intratumoral temperature to 39-44°C. Various types of hyperthermia exist including local hyperthermia, regional hyperthermia, whole-body hyperthermia, interstitial and endocavitary hyperthermia, hyperthermic isolated limb perfusion, hyperthermic intraperitoneal chemotherapy (HIPEC) and hyperthermic intravesical chemotherapy (HIVEC). The most used technologies to induce hyperthermia include radiofrequency, microwave, or ultrasound. Local and regional hyperthermia (locoregional; LRHT) are among the most used and studied and are the focus of this monograph. HT is purported to have several mechanisms of action through which it may act against cancer including physiological changes such as vasodilation, direct cytotoxic effects, chemosensitizing and radiosensitizing actions, and immune modulation. LRHT is used primarily as an adjunct to chemotherapy and radiotherapy due to its ability to sensitize malignant tissues to these treatments. Various studies have demonstrated improved outcomes for patients treated with HT alongside chemo-and/orradiotherapy. The best evidence for improved disease control and survival are for breast cancer (locally recurrent), cervical cancer, esophageal and gastric cancers, head and neck squamous cell carcinoma, and high-risk soft tissue sarcoma. Research related to quality of life (QOL) is limited, and thus not a primary indication. Hyperthermia with modern technology and treatment planning is generally well tolerated; the most common side effects are discomfort, mild pain, local erythema, and thermal skin burns. Less commonly, subcutaneous burns are a possible adverse effect. Despite promising research, trial heterogeneity and methodological concerns limit the strength of the conclusions that can be drawn. In the future, more high-quality studies with proper quality assurance and treatment planning are needed to ensure consistency and reproducibility.