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Clinical Instrumentation Requirements with a Review of the Perth Hyperthermia Experience¹

Division of Radiation Oncology, Department of Human Oncology, University of Wisconsin Center for Health Sciences, 600 Highland Avenue, Madison, Wisconsin 53792

The problems of precise clinical thermometry are enormous, and, because the degree of sensitization to ionizing radiation is strongly dependent on temperature and time at temperature, it is important that this problem be solved in a practical way. In lieu of accurate temperature-recording methods, it is imperative that any clinical treatment regimens which utilize heating be with temperatures which are elevated only moderately (to perhaps a maximum of 41°C).

With external heating methods, tumors with sluggish blood flow can be heated to a greater degree than normal tissues. This should be particularly true for hypoxic foci which are at some distance from cooling capillaries. Unfortunately, it seems unlikely that practical detectors can be designed to measure the temperatures of these crucial microenvironments. Hence, this is another reason why it may be necessary to be cautiously empirical about certain aspects of clinical treatment approaches utilizing hyperthermia.

J. A. G. Holt and A. J. M. Nelson's experience in 52 patients with head and neck cancer treated with 434 MHz microwave hyperthermia and ionizing irradiation in Perth, Western Australia, was reviewed during my visit there in the spring of 1978. The two-year disease-free survival of 47% for patients with advanced disease (T₃, T₄ or N₂, N₃) is promising. This is especially encouraging since these results were obtained with lower than conventional doses of irradiation and normal tissue tolerance was excellent. Phase I and II studies in this country appear warranted.

¹ Presented at the Conference on Hyperthermia in Cancer Treatment, September 15 and 16, 1978, San Diego, Calif. Supported in part by the National Cancer Institute, Wisconsin Clinical Cancer Center Grant, Multidisciplinary Program in Radiation Oncology, 5-PO1-CA-19278-03.