A new technique called regional hyperthermia (RHT) makes chemotherapy more effective and improves outcomes in patients with soft tissue sarcoma, according to the results of a study presented on September 22, 2009 at Europe’s largest cancer congress, ECCO 15-ESMO 34, in Berlin.
Soft tissue sarcomas are cancers that affect the connective and supportive tissues, which include bones, muscles, tendons, ligaments, fat, blood vessels, and fibrous tissues. Sarcomas are relatively uncommon, but when they do occur they tend to affect children and young adults. The primary treatment for sarcoma is surgery; however, because of the difficulty in removing these tumors, they are often treated with radiation and chemotherapy as well. Survival for this disease varies depending on the location and size of the tumor. Patients who are considered high-risk typically relapse within two or three years.
Regional hyperthermia is a technique that uses electromagnetic energy to heat the tissue in and around the tumor to between 104-109 degrees Fahrenheit. The heat kills cancer cells and also improves blood flow and makes cancer cells more sensitive, thereby improving the efficacy of chemotherapy.
Researchers in Europe and the U.S. conducted a Phase III study that involved 341 patients with locally advanced soft tissue sarcomas that were at high risk of recurrence and spread. All patients underwent chemotherapy both before and after surgery and radiation. Half of the patients in the study were randomized to undergo RHT along with chemotherapy. The results indicate that the new technique improved outcomes for patients.
After an average follow-up period of 34 months, patients who received chemotherapy plus RHT were 44% less likely to die during the follow-up period than those who received chemotherapy alone. Furthermore, patients who received the RHT remained disease-free 30% longer than their counterparts—32 months compared with 18 months in the chemotherapy-alone group.
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Additionally, RHT was shown to shrink tumors—28.8% of patients experienced tumor shrinkage compared with 12.7% of those who received chemotherapy alone. RHT patients also experienced less tumor growth, with 6.8% of patients having tumor growth compared with 20% of patients who received chemotherapy alone.
The researchers concluded that the targeted heat therapy significantly improves overall response rates, time to progression, local progression-free survival and disease-free survival. The most common side effect of the therapy was mild to moderate discomfort. One patient experienced severe burns.
Research will likely be ongoing to evaluate this new treatment technique for sarcoma and other types of cancer.
 Issels R, Lindner H, Wendtner CM, et al. Impact of regional hyperthermia (RHT) on response to neoadjuvant chemotherapy and survival of patients with high-risk soft-tissue sarcoma (HR-STS): Results of the randomized EORTC-ESHO intergroup trial (NCI-00003052). European Journal of Cancer Supplements, Vol. 7, No. 3, September 2009. Abstract 1 LBA.
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