Department of Radiation Oncology, University Hospital Erlangen, Universitatsstr 27, 91054 Erlangen, Germany.
Curr Med Chem. 2010;17(27):3045-57. doi: 10.2174/092986710791959774.
Hyperthermia (HT)--heating the tumor in the range of 40.0- 44.0 °C--combined with radiation (RT) and/or chemotherapy (CT) is a well proven treatment for malignant tumors. The improvement of the techniques for monitoring and adapting of the desired temperatures even in deep seated tumors has led to a renaissance of, now quality-controlled, HT in multimodal tumor therapy approaches. Randomized clinical trials have shown improved disease-free survival and local tumor control without an increase in toxicity for the combined treatment. In this review, we will focus on biological rationales of HT comprising direct cytotoxicity, systemic effects, chemosensitization, radiosensitization, and immune modulation. The latter is a prerequisite for the control of recurrent tumors and micrometastases. Immunogenic tumor cell death forms induced by HT will be introduced. Modulations of the cytotoxic properties of chemotherapeutic agents by HT as well as synergistic effects of HT with RT will be presented in the context of the main aims of anti-tumor therapy. Furthermore, modern techniques for thermal mapping like magnet resonance imaging will be outlined. The effectiveness of HT will be demonstrated by reviewing recent clinical trials applying HT in addition to CT and/or RT. We conclude that hyperthermia is a very potent radio- as well as chemosensitizer, which fosters the induction of immunogenic dead tumor cells leading to local and in special cases also to systemic tumor control.
高热疗法（HT）——将肿瘤加热至 40.0-44.0°C 范围——联合放射治疗（RT）和/或化学治疗（CT）是一种经过充分验证的治疗恶性肿瘤的方法。监测和适应所需温度的技术的改进，即使在深部肿瘤中，也导致了高热疗法在多模式肿瘤治疗方法中的复兴，现在可以进行质量控制。随机临床试验表明，联合治疗可提高无病生存率和局部肿瘤控制率，而毒性没有增加。在这篇综述中，我们将重点介绍包括直接细胞毒性、全身效应、化疗增敏、放疗增敏和免疫调节在内的 HT 的生物学原理。后者是控制复发性肿瘤和微转移的前提。我们将介绍由 HT 诱导的免疫原性肿瘤细胞死亡形式。HT 对化疗药物细胞毒性的调节以及 HT 与 RT 的协同作用将在抗肿瘤治疗的主要目标的背景下进行介绍。此外，还将概述像磁共振成像这样的热图绘制现代技术。通过回顾最近的临床试验，我们将证明 HT 的有效性，这些试验将 HT 应用于 CT 和/或 RT 之外。我们得出结论，高热疗法是一种非常有效的放疗和化疗增敏剂，它促进了免疫原性死亡肿瘤细胞的诱导，从而实现局部和在特殊情况下也实现全身肿瘤控制。
