[Interstitial Ir-192 afterloading therapy with sequential warm-water hyperthermia].

For selective heating of superficially located or easily accessible tumors interstitial hyperthermia has become an increasing popular method in combination with interstitial radioactive implants. At our institution the hyperthermia treatment is performed utilizing the warm water system KHS-9, which is adapted to our Ir-192 high-dose-rate afterloading device, so that the same hollow needles for the interstitial radiation can be used for the heating procedure. So far, this technique has been applied for the treatment of primary and carcinomas, gynecological recurrences, and metastases of malignant melanomas after preceding in vitro measurements of temperature distribution. As a result both, in vitro and in vivo investigations showed good homogeneity of the temperature throughout the heated volume. Analysing the temperature data of in vivo measurements the maximum deviation of temperature was found to be 1.5 degrees C. When using a needle spacing of 8 mm, the temperature required for clinical application (42.5 degrees C) could be maintained in all heat treatments with a preselected water temperature of 46 degrees C to 49.5 degrees C.