Evaluation of thermal dose effect in radiofrequency-induced hyperthermia with intravesical chemotherapy for nonmuscle invasive bladder cancer
AbstractPurpose In nonmuscle invasive bladder cancer (NMIBC) patients who fail standard intravesical treatment and are unfit or unwilling to undergo a radical cystectomy, radiofrequency (RF)-induced hyperthermia combined with intravesical chemotherapy (RF-CHT) has shown promising results. We studied...
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| 格式: | 文件 |
| 语言: | English |
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Taylor & Francis Group
2023-12-01
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| 丛编: | International Journal of Hyperthermia |
| 主题: | |
| 在线阅读: | https://www.tandfonline.com/doi/10.1080/02656736.2022.2157498 |
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| author | Iris S. G. Brummelhuis Johannes Crezee J. Alfred Witjes |
| author_facet | Iris S. G. Brummelhuis Johannes Crezee J. Alfred Witjes |
| author_sort | Iris S. G. Brummelhuis |
| collection | DOAJ |
| description | AbstractPurpose In nonmuscle invasive bladder cancer (NMIBC) patients who fail standard intravesical treatment and are unfit or unwilling to undergo a radical cystectomy, radiofrequency (RF)-induced hyperthermia combined with intravesical chemotherapy (RF-CHT) has shown promising results. We studied whether higher thermal dose improves clinical NMIBC outcome.Methods and materials The cohort comprised 108 patients who started with RF-CHT between November 2013 and December 2019. Patients received intravesical mitomycin-C or epirubicin. Bladder hyperthermia was accomplished with an intravesical 915 MHz RF device guided by intravesical thermometry. We assessed the association between thermal dose parameters (including median temperature and Cumulative Equivalent Minutes of T50 at 43 °C [CEM43T50]) and complete response (CR) at six months for patients with (concomitant) carcinoma in situ (CIS), and recurrence-free survival (RFS) for patients with papillary disease.Results Median temperature and CEM43T50 per treatment were 40.9 (IQR 40.8–41.1) °C and 3.1 (IQR 0.9–2.4) minutes, respectively. Analyses showed no association between any thermal dose parameter and CR or RFS (p > 0.05). Less bladder spasms during treatment sessions was associated with increased median temperature and CEM43T50 (adjusted OR 0.01 and 0.34, both p < 0.001).Conclusions No significant association between thermal dose and NMIBC outcome was found. Possibly thermal dose effect in patients of the current cohort exceeds a certain threshold value. On the other hand, occurrence of bladder spasms had a thermal dose limiting effect. We advise to treat patients with temperatures >40.5 °C for at least 45 min while respecting individual tolerability, including occurrence of bladder spasms. |
| first_indexed | 2024-03-08T19:02:58Z |
| format | Article |
| id | doaj.art-8950074b5392418f81edcd8d34259095 |
| institution | Directory Open Access Journal |
| issn | 0265-6736 1464-5157 |
| language | English |
| last_indexed | 2024-03-08T19:02:58Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | International Journal of Hyperthermia |
| spelling | doaj.art-8950074b5392418f81edcd8d342590952023-12-28T04:15:42ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572023-12-0140110.1080/02656736.2022.2157498Evaluation of thermal dose effect in radiofrequency-induced hyperthermia with intravesical chemotherapy for nonmuscle invasive bladder cancerIris S. G. Brummelhuis0Johannes Crezee1J. Alfred Witjes2Department of Urology, Radboud University Medical Center, Nijmegen, The NetherlandsDepartment of Radiotherapy, Amsterdam University Medical Centers, Cancer Center Amsterdam, University of Amsterdam, Amsterdam, The NetherlandsDepartment of Urology, Radboud University Medical Center, Nijmegen, The NetherlandsAbstractPurpose In nonmuscle invasive bladder cancer (NMIBC) patients who fail standard intravesical treatment and are unfit or unwilling to undergo a radical cystectomy, radiofrequency (RF)-induced hyperthermia combined with intravesical chemotherapy (RF-CHT) has shown promising results. We studied whether higher thermal dose improves clinical NMIBC outcome.Methods and materials The cohort comprised 108 patients who started with RF-CHT between November 2013 and December 2019. Patients received intravesical mitomycin-C or epirubicin. Bladder hyperthermia was accomplished with an intravesical 915 MHz RF device guided by intravesical thermometry. We assessed the association between thermal dose parameters (including median temperature and Cumulative Equivalent Minutes of T50 at 43 °C [CEM43T50]) and complete response (CR) at six months for patients with (concomitant) carcinoma in situ (CIS), and recurrence-free survival (RFS) for patients with papillary disease.Results Median temperature and CEM43T50 per treatment were 40.9 (IQR 40.8–41.1) °C and 3.1 (IQR 0.9–2.4) minutes, respectively. Analyses showed no association between any thermal dose parameter and CR or RFS (p > 0.05). Less bladder spasms during treatment sessions was associated with increased median temperature and CEM43T50 (adjusted OR 0.01 and 0.34, both p < 0.001).Conclusions No significant association between thermal dose and NMIBC outcome was found. Possibly thermal dose effect in patients of the current cohort exceeds a certain threshold value. On the other hand, occurrence of bladder spasms had a thermal dose limiting effect. We advise to treat patients with temperatures >40.5 °C for at least 45 min while respecting individual tolerability, including occurrence of bladder spasms.https://www.tandfonline.com/doi/10.1080/02656736.2022.2157498Urinary bladder neoplasmsnonmuscle invasive bladder cancerhyperthermiaintravesical chemotherapy instillationthermal dose |
| spellingShingle | Iris S. G. Brummelhuis Johannes Crezee J. Alfred Witjes Evaluation of thermal dose effect in radiofrequency-induced hyperthermia with intravesical chemotherapy for nonmuscle invasive bladder cancer International Journal of Hyperthermia Urinary bladder neoplasms nonmuscle invasive bladder cancer hyperthermia intravesical chemotherapy instillation thermal dose |
| title | Evaluation of thermal dose effect in radiofrequency-induced hyperthermia with intravesical chemotherapy for nonmuscle invasive bladder cancer |
| title_full | Evaluation of thermal dose effect in radiofrequency-induced hyperthermia with intravesical chemotherapy for nonmuscle invasive bladder cancer |
| title_fullStr | Evaluation of thermal dose effect in radiofrequency-induced hyperthermia with intravesical chemotherapy for nonmuscle invasive bladder cancer |
| title_full_unstemmed | Evaluation of thermal dose effect in radiofrequency-induced hyperthermia with intravesical chemotherapy for nonmuscle invasive bladder cancer |
| title_short | Evaluation of thermal dose effect in radiofrequency-induced hyperthermia with intravesical chemotherapy for nonmuscle invasive bladder cancer |
| title_sort | evaluation of thermal dose effect in radiofrequency induced hyperthermia with intravesical chemotherapy for nonmuscle invasive bladder cancer |
| topic | Urinary bladder neoplasms nonmuscle invasive bladder cancer hyperthermia intravesical chemotherapy instillation thermal dose |
| url | https://www.tandfonline.com/doi/10.1080/02656736.2022.2157498 |
| work_keys_str_mv | AT irissgbrummelhuis evaluationofthermaldoseeffectinradiofrequencyinducedhyperthermiawithintravesicalchemotherapyfornonmuscleinvasivebladdercancer AT johannescrezee evaluationofthermaldoseeffectinradiofrequencyinducedhyperthermiawithintravesicalchemotherapyfornonmuscleinvasivebladdercancer AT jalfredwitjes evaluationofthermaldoseeffectinradiofrequencyinducedhyperthermiawithintravesicalchemotherapyfornonmuscleinvasivebladdercancer |