Modulated Electro-Hyperthermia as Palliative Treatment for Pancreatic Cancer: A Retrospective Observational Study on 106 Patients:

Published on Sep 27, 2019in Integrative Cancer Therapies2.379
· DOI :10.1177/1534735419878505
Giammaria Fiorentini25
Estimated H-index: 25
Donatella Sarti9
Estimated H-index: 9
+ 6 AuthorsStefano Guadagni22
Estimated H-index: 22
(University of L'Aquila)
Background: Pancreatic adenocarcinoma has a poor prognosis, resulting in a <10% survival rate at 5 years. Modulated electro-hyperthermia (mEHT) has been increasingly used for pancreatic cancer pall...
#1Lei Huang (DKFZ: German Cancer Research Center)H-Index: 17
#2Yesilda Balavarca (DKFZ: German Cancer Research Center)H-Index: 13
Last. Lina Jansen (DKFZ: German Cancer Research Center)H-Index: 38
view all 15 authors...
Background Pancreatic cancer (PaC) remains extremely lethal worldwide even after resection. PaC resection rates are low, making prognostic studies in resected PaC difficult. This large international population-based study aimed at exploring factors associated with survival in patients with resected TNM stage I–II PaC receiving chemotherapy and at developing and internationally validating a survival-predicting model.
14 CitationsSource
One of the most frequently applied bioelectromagnetic effects is the deep heating of the living species with EMF energy. Despite its long history, hyperthermia is a rarely applied oncotherapy. The reason is its controversial results and complicated control. One of the solutions is concentrating the electromagnetic energy nanoscopically on the parts of the malignant cells instead of heating up the complete tumor-mass. This approach is a kind of non-uniform energy absorption, providing energy libe...
4 CitationsSource
#2Donatella SartiH-Index: 9
Last. Stefano Guadagni (University of L'Aquila)H-Index: 22
view all 9 authors...
Background: There are interesting studies on glioma therapy with modulated electrohyperthermia (mEHT), which combines heat therapy with an electric field. Clinical researchers not only found the mEHT method feasible for palliation but also reported evidence of therapeutic response. Purpose: To study the efficacy and safety of mEHT for the treatment of relapsed malignant glioma and astrocytoma versus best supportive care (BSC). Methods: We collected data retrospectively on 149 patients affected b...
15 CitationsSource
#1Andrew McGuigan ('QUB': Queen's University Belfast)H-Index: 1
#2Paul KellyH-Index: 36
Last. R Stephen McCain (Mater Health Services)H-Index: 3
view all 6 authors...
: This review aims to outline the most up-to-date knowledge of pancreatic adenocarcinoma risk, diagnostics, treatment and outcomes, while identifying gaps that aim to stimulate further research in this understudied malignancy. Pancreatic adenocarcinoma is a lethal condition with a rising incidence, predicted to become the second leading cause of cancer death in some regions. It often presents at an advanced stage, which contributes to poor five-year survival rates of 2%-9%, ranking firmly last a...
341 CitationsSource
#1Astrid van der Horst (UvA: University of Amsterdam)H-Index: 19
#2Eva Versteijne (UvA: University of Amsterdam)H-Index: 11
Last. Geertjan van Tienhoven (UvA: University of Amsterdam)H-Index: 35
view all 13 authors...
AbstractObjective: In pancreatic cancer, which is therapy resistant due to its hypoxic microenvironment, hyperthermia may enhance the effect of radio(chemo)therapy. The aim of this systematic review is to investigate the validity of the hypothesis that hyperthermia added to radiotherapy and/or chemotherapy improves treatment outcome for pancreatic cancer patients.Methods and materials: We searched MEDLINE and Embase, supplemented by handsearching, for clinical studies involving hyperthermia in p...
17 CitationsSource
Combined radiotherapy (RT) and hyperthermia (HT) treatments may improve treatment outcome by heat induced radio-sensitisation. We propose an empirical cell survival model (AlphaR model) to describe this multimodality therapy. The model is motivated by the observation that heat induced radio-sensitisation may be explained by a reduction in the DNA damage repair capacity of heated cells. We assume that this repair is only possible up to a threshold level above which survival will decrease exponent...
13 CitationsSource
#1Wonwoo KimH-Index: 6
#2Mi-Sook KimH-Index: 20
Last. Won Il JangH-Index: 14
view all 8 authors...
AbstractPurpose: Mild temperature hyperthermia (MTH) increases blood flow and oxygenation in tumours. On the other hand, high-dose-per-fraction irradiation damages blood vessels, decreases blood flow and increases hypoxia in tumours. The radiation-induced hypoxia in tumours activates hypoxia-inducible factor-1α (HIF-1α) and its target genes, such as vascular endothelial growth factor (VEGF), promoting revascularization and recurrence. In the present study, we examined the hypothesis that MTH inh...
16 CitationsSource
#1Niloy R. DattaH-Index: 20
#2Bernhard C. Pestalozzi (UZH: University of Zurich)H-Index: 33
Last. Stephan Bodis (UZH: University of Zurich)H-Index: 31
view all 11 authors...
Pancreatic cancer has a dismal prognosis with 5-year overall survival rate of around 5%. Although surgery is still the best option in operable cases, majority of the patients who present in locally advanced stages are deemed inoperable. Novel approaches are therefore needed for the management of around 80% of these inoperable locally advanced pancreatic cancers (LAPC). Hyperthermia (39–43 °C) is a potent radiosensitizer and further enhances the action of gemcitabine, also a known radiosensitizer...
11 CitationsSource
#1Daniel Ansari (Lund University)H-Index: 25
#2Stina Kristoffersson (Lund University)H-Index: 1
Last. Magnus Bergenfeldt (Lund University)H-Index: 12
view all 4 authors...
AbstractObjectives: Irreversible electroporation (IRE) is a new modality for tumor ablation. Electrodes are placed around the tumor, and a pulsed, direct current with a field strength of 2000 V/cm is delivered. The direct current drives cells into apoptosis and cell death without causing significant heating of the tissues, which spares the extracellular matrix and proteins. The purpose of this review was to evaluate current experience of IRE for the ablation of pancreatic cancer.Material and met...
40 CitationsSource
As an angiogenesis inhibitor, bevacizumab has been investigated in combination with different chemotherapeutic agents, achieving an established role for metastatic cancer treatment. However, potential synergic anti-angiogenic effects of hyperthermia have not tested to date in literature. The aim of our study was to analyze efficacy, safety, and survival of anti-angiogenic-based chemotherapy associated to regional deep capacitive hyperthermia (HT) in metastatic cancer patients. Twenty-three patie...
11 CitationsSource
Cited By8
#1Takuya Nagata (Toho University)
#2Masahiko Kanamori (University of Toyama)H-Index: 27
Last. Tsutomu Fujii (University of Toyama)H-Index: 10
view all 6 authors...
Modulated electro-hyperthermia (mEHT) is a new treatment modality developed to overcome the problems associated with traditional hyperthermia; mEHT uses a precise impedance-matched system and modulated radiofrequency current flow to malignant tumors. It selects the malignant cells based on their biophysical differences, due to their high metabolic rate, individual (autonomic) behavior and membrane status. The aim of the present study was to report the outcomes of mEHT in the treatment of advance...
#1Felista L. Tansi (FSU: University of Jena)H-Index: 7
#2Wisdom O. Maduabuchi (FSU: University of Jena)
Last. Ingrid Hilger (FSU: University of Jena)H-Index: 42
view all 9 authors...
OBJECTIVE Deep-tissue localization of thermal doses is a long-standing challenge in magnetic field hyperthermia (MFH), and remains a limitation of the clinical application of MFH to date. Here, we show that pulse sequencing of MFH leads to a more persistent inhibition of tumor growth and less systemic impact than continuous MFH, even when delivering the same thermal dose. METHODS We used an in vivo orthotopic murine model of pancreatic PANC-1 cancer, which was designed with a view to the forthco...
#2Donatella SartiH-Index: 9
Last. Stefano Guadagni (University of L'Aquila)H-Index: 22
view all 8 authors...
The role of hyperthermia (HT) in cancer therapy and palliative care has been discussed for years in the literature. There are plenty of articles that show good feasibility of HT and its efficacy in terms of tumor response and survival improvements. Nevertheless, HT has never gained enough interest among oncologists to become a standard therapy in clinical practice. The main advantage of HT is the enhancement of chemotherapy (CHT), radiotherapy (RT), chemoradiotherapy (CRT), and immunotherapy ben...
1 CitationsSource
#1Sun Young Lee (CBNU: Chonbuk National University)H-Index: 9
Last. Carrie Anne Minnaar (University of the Witwatersrand)H-Index: 5
view all 6 authors...
Heating as a medical intervention in cancer treatment is an ancient approach, but effective deep heating techniques are lacking in modern practice. The use of electromagnetic interactions has enabled the development of more reliable local-regional hyperthermia (LRHT) techniques whole-body hyperthermia (WBH) techniques. Contrary to the relatively simple physical-physiological concepts behind hyperthermia, its development was not steady, and it has gone through periods of failures and renewals wit...
1 CitationsSource
#1Tibor Krenács (Semmelweis University)H-Index: 29
#2Nora Meggyeshazi (Semmelweis University)H-Index: 9
Last. Tamás Vancsik (Semmelweis University)H-Index: 5
view all 7 authors...
The benefits of high-fever range hyperthermia have been utilized in medicine from the Ancient Greek culture to the present day. Amplitude-modulated electro-hyperthermia, induced by a 13.56 MHz radiofrequency current (mEHT, or Oncothermia), has been an emerging means of delivering loco-regional clinical hyperthermia as a complementary of radiation-, chemo-, and molecular targeted oncotherapy. This unique treatment exploits the metabolic shift in cancer, resulting in elevated oxidative glycolysis ...
6 CitationsSource
#1Gertrud Forika (Semmelweis University)H-Index: 4
#2Andrea Balogh (Semmelweis University)H-Index: 4
Last. Tibor Krenács (Semmelweis University)H-Index: 29
view all 7 authors...
The poor outcome of pancreas ductal adenocarcinomas (PDAC) is frequently linked to therapy resistance. Modulated electro-hyperthermia (mEHT) generated by 13.56 MHz capacitive radiofrequency can induce direct tumor damage and promote chemo- and radiotherapy. Here, we tested the effect of mEHT either alone or in combination with radiotherapy using an in vivo model of Panc1, a KRAS and TP53 mutant, radioresistant PDAC cell line. A single mEHT shot of 60 min induced ~50% loss of viable cells and mor...
4 CitationsSource
#1Patrick Hung-Ju Kao (Memorial Hospital of South Bend)
#2Chia-Hung Chen (NCTU: National Chiao Tung University)H-Index: 7
Last. Yu-Shan Wang (NTU: National Taiwan University)H-Index: 4
view all 13 authors...
Modulated electro-hyperthermia (mEHT) is a form of mild hyperthermia (HT) used for cancer treatment. The principle utility of HT is the ability not only to increase cell temperature, but also to increase blood flow and associated pO2 to the microenvironment. While investigational evidence has shown the unique ability of mEHT to elicit apoptosis in cancer cells, in vivo and in vitro, the same trait has not been observed with conventional HT. There is dissension as to what allows mEHT to elicit ap...