Guidelines on whole-body hyperthermia
Whole-body hyperthermia (WBHT) or “systemic hyperthermia”, defined as a controlled increase in the core body temperature for therapeutic purposes, is one of the oldest forms of therapy in the history of medicine, with a very wide range of indications, and has been passed down by most cultures. Frequently cited, in this respect, is the dictum attributed to Hippocrates:
“Fever is an endeavour on the part of the human organism to heal sickness. It cleanses the body like fire”.
WBHT is based, inter alia, on the positive assessment of the natural mechanism of fever caused by infection, inherent in all warm-blooded mammals, where an increase in the core body temperature functions as a significant component in initiating and controlling an extraordinary immune response. Numerous pre-clinical trials confirm the therapeutic potential of a controlled increase in the core body temperature, and throw more and more light on the underlying biological mechanisms.
In a number of non-oncological and oncological indication ranges, the efficacy of WBHT has been evidenced by clinical trials at various evidential levels. As modes of action, the increase in perfusion and metabolism, as well as effects on the hormone and immune system, associated with the increase in the core body temperature, can be specified. In that respect, the area of WBHT extends from mild applications of heat, that can also be carried out at home, to the realm of the actual “fever temperatures” and extreme WBHT, as used in intensive medicine. Such a range makes clear definitions and differentiations indispensable.
Guidelines on capacitive local radio frequency hyperthermia
Capacitive radio frequency hyperthermia is a well-investigated, promising therapy in oncology. The results of experimental and clinical trials indicate that hyperthermia is an ideal complementary treatment and a strong sensitizer for radiotherapy and/or chemotherapy. New technical methods and comprehensive experimental and clinical trials have confirmed the efficiency, and justify its use in cancer therapy to the benefit of the patients.
The effects of the capacitive RF hyperthermia upon biological structures are pleiotropic and complex. Besides the method, they are dependent upon the temperature, the duration of the application, the heating-up time, and also the form, nature and size of the tissue, the blood supply and the homogeneity of the temperature distribution. They range from the denaturation of cellular and sub-cellular elements to the influencing of the entire tumour tissue and the environment of the tumour – inter alia, also due to the electromagnetic fields that exist mandatorily, which make the increase in the temperature of the tissue possible in the first place. A large number of publications reports on positive effects of the combined hyperthermia treatment and radiotherapy. On this basis, the present guidelines summarise the current state of knowledge.