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Page Columns
1/2 Half page
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1/2 Half page
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Numerosi studi clinici dimostrano un aumento della risposta completa con scomparsa clinica del tumore quando alla radio o alla chemioterapia viene aggiunta l’ipertermia. Mediamente, l’incremento della risposta si aggira attorno al 35% e riguarda i tumori della mammella, del collo uterino, i sarcomi delle parti molli,i tumori della vescica,il glioblastoma cerebrale e i tumori della regione del capo-collo. L’ipertermia, essendo un potente radio e chemio-sensibilizzante aumenta l’efficacia delle cure convenzionali senza aggiungere tossicità. Inoltre essa funziona come immuno-modulante ed è in grado di stimolare il sistema di difesa naturale del paziente in terapia che spesso viene depresso dai farmaci oncologici e dalle radiazioni ionizzanti impiegate in radioterapia. Gran parte di questi studi sono stati condotti mediante sorteggio dei pazienti (random) che casualmente confluivano parte nel gruppo sperimentale, dove la ipertermia veniva aggiunta al trattamento standard e parte nel gruppo di controllo dove si eseguiva la sola terapia convenzionale, in genere radio o/e chemioterapia. Queste ricerche cliniche, i cui risultati non sono manipolabili dai ricercatori essendo la scelta dei pazienti affidata al caso, vengono definite studi randomizzati
(Tab 2) Vari studi clinici randomizzati hanno documentato l’efficacia della ipertermia aggiunta alla radio o chemioterapia nei tumori dell’ esofago, pancreas, retto, ano e melanoma con livelli di massima evidenza. Questi studi sono stati rivalutati nel corso della Consensus Conference di Osaka del 2004 che ha riunito vari esperti da tutto il mondo scientifico e dato il via alla moderna ipertermia oncologica. Le linee guida emerse da questo confronto sono state pubblicate su International Journal of Hyperthermia nel 2008 (vol 24 n°2). Questi studi, ed altri che sono seguiti, consentono ora alla ipertermia di essere inclusa in alcune linee-guida internazionali e di avere uno spazio di tutto rispetto tra le diverse terapie oncologiche.
Bibliografia
- Ann Oncol. 2002 Aug;13(8):1173-84.Heating the patient: a promising approach? van der Zee J.
- 2010 Nov-Dec;96(6):902-10. The role of hyperthermia in the battle against cancer. Palazzi M, Maluta S, Dall'Oglio S, Romano M.