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  1. Pastore C, Fioranelli M (2017) Rescue Therapy in Patient with NSCLC with the Combination of Chemotherapy and Hyperthermia. Intern Med 7: 256. doi:10.4172/2165-8048.1000256

  2. Pastore C, Fioranelli M, Roccia MG (2017) Rescue Therapy in Patient with Glioblastoma Multiforme Combining Chemotherapy, Hyperthermia, Phytotherapy. J Integr Oncol 6: 199. doi:10.4172/2329-6771.1000199



(parte riservata ai medici)




  1. Am J Clin Oncol. 2005 Feb;28(1):91-9.Chemoradiotherapy combined with intracavitary hyperthermia for anal cancer: feasibility and long-term results from a phase II randomized trial. Kouloulias V, Plataniotis G, Kouvaris J, Dardoufas C, Gennatas C, Uzunoglu N, Papavasiliou C, Vlahos L.



  1. Vopr Onkol. 2013;59(5):571-4.Conservative thermochemoradiation therapy of locally advanced laryngeal cancer. Kurpeshev OK, Andreev VG, Pankratov VA, Gulidov IA, Orlova AV.


  1. Clin Transl Oncol. 2013 Feb;15(2):95-105.Radiotherapy in conjunction with superficial and intracavitary hyperthermia for the treatment of solid tumors: survival and thermal parameters. Triantopoulou S, Efstathopoulos E, Platoni K, Uzunoglou N, Kelekis N, Kouloulias V.



  1. Int J Radiat Oncol Biol Phys. 2012 Aug 1;83(5):e639-45.Thermochemoradiation therapy using superselective intra-arterial infusion via superficial temporal and occipital arteries for oral cancer with N3 cervical lymph node metastases. Mitsudo K, Koizumi T, Iida M, Iwai T, Oguri S, Yamamoto N, Itoh Y, Kioi M, Hirota M, Tohnai I.


  1. J Cancer Res Ther. 2010 Oct-Dec;6(4):492-6.Hyperthermia with radiation in the treatment of locally advanced head and neck cancer: a report of randomized trial. Huilgol NG, Gupta S, Sridhar CR.



  1. Biomed Eng Online. 2012 Aug 14;11:47 FDTD analysis of a noninvasive hyperthermia system for brain tumors.Yacoob SM, Hassan NS.


  1. 2012 Aug;83(8):982-7. Treatment of brain tumor patients: hyperthermia, hyperbaric oxygenation, electric fields or nanoparticles. Platten M, Wick W.


  1. Int J Radiat Oncol Biol Phys. 1998 Jan 15;40(2):287-95.Survival benefit of hyperthermia in a prospective randomized trial of brachytherapy boost +/- hyperthermia for glioblastoma multiforme. Sneed PK, Stauffer PR, McDermott MW, Diederich CJ, Lamborn KR, Prados MD, Chang S, Weaver KA, Spry L, Malec MK, Lamb SA, Voss B, Davis RL, Wara WM, Larson DA, Phillips TL, Gutin PH.



  1. Journal of Neuro-Oncology, June 2011, Volume 103, Issue 2, pp 317-324.Efficacy and safety of intratumoral thermotherapy using magnetic iron-oxide nanoparticles combined with external beam radiotherapy on patients with recurrent glioblastoma multiforme. Klaus Maier-Hauff, Frank Ulrich, Dirk Nestler, Hendrik Niehoff, Peter Wust, Burghard Thiesen, Helmut Orawa, Volker Budach, Andreas Jordan




  1. Int J Hyperthermia. 2012;28(6):543-8.Review of radiotherapy and hyperthermia in primary cervical cancer. Franckena M.


  1. Med Phys. 2011 Feb;38(2):598-611.Endocervical ultrasound applicator for integrated hyperthermia and HDR brachytherapy in the treatment of locally advanced cervical carcinoma. Wootton JH, Hsu IC, Diederich CJ.



  1. J Vasc Interv Radiol. 2013 Dec 5. pii: S1051-0443(13)01543-1.Localized Hyperthermia with Iron Oxide-Doped Yttrium Microparticles: Steps toward Image-Guided Thermoradiotherapy in Liver Cancer. Gordon AC, Lewandowski RJ, Salem R, Day DE, Omary RA, Larson AC.


  1. World J Gastroenterol. 2013 May 21;19(19):2956-62.Intraperitoneal perfusion of cytokine-induced killer cells with local hyperthermia for advanced hepatocellular carcinoma.Wang XP, Xu M, Gao HF, Zhao JF, Xu KC.



  1. Surg Oncol Clin N Am. 2013 Jul;22(3):545-61.Novel approaches to treatment of hepatocellular carcinoma and hepatic metastases using thermal ablation and thermosensitive liposomes. Dewhirst MW, Landon CD, Hofmann CL, Stauffer PR.



  1. Clin Transl Oncol. 2010 Sep;12(9):621-8. Revised guidelines for second-look surgery in patients with colon and rectal cancer. Sugarbaker PH.


  1. Dis Colon Rectum. 1997 Nov;40(11):1303-12.Synergistic effects of hyperthermia in preoperative radiochemotherapy for rectal carcinoma. Furuta K, Konishi F, Kanazawa K, Saito K, Sugawara T.


  1. Recent Results Cancer 1998;146:175-91.Radiochemotherapy and hyperthermia in the treatment of rectal cancer. Wust P, Rau B, Gellerman J, Pegios W, Löffel J, Riess H, Felix R, Schlag P


  1. J Radiat Res. 2011;52(6):812-20. Multimodal approaches including three-dimensional conformal re-irradiation for recurrent or persistent esophageal cancer: preliminary results. Yamaguchi S, Ohguri T, Imada H, Yahara K, Moon SD, Higure A, Yamaguchi K, Yoshikawa I, Harada M, Korogi Y.


  1. Dis Esophagus. 2010 Nov;23(8):E42-7. Radiotherapy combined with hyperthermia for primary malignant melanomas of the esophagus. Hulshof MC, Van Haaren PM, Zum Vörde Sive Vörding PJ, Krishnadath S, Marsman WA, Van Berge Henegouwen MI, Geijsen ED, Crezee J.


  1. Int J Hyperthermia. 2011;27(1):20-6.Deep regional hyperthermia for the whole thoracic region using 8 MHz radiofrequency-capacitive heating device: relationship between the radiofrequency-output power and the intra-oesophageal temperature and predictive factors for a good heating in 59 patients. Ohguri T, Yahara K, Moon SD, Yamaguchi S, Imada H, Terashima H, Korogi Y.


  1. Int J Hyperthermia. 2009 Feb;25(1):79-85. Preoperative chemoradiation combined with regional hyperthermia for patients with resectable esophageal cancer. Hulshof MC, Van Haaren PM, Van Lanschot JJ, Richel DJ, Fockens P, Oldenborg S, Geijsen ED, Van Berge Henegouwen MI, Crezee J.




  1. Zhongguo Gu Shang. 2013 Apr;26(4):354-6.Update of research on hyperthermia in relief of bone metastasis pain. Gao Y, Gou T, Feng L, Wang F.


  1. Pathol Oncol Res. 2013 Jan;19(1):119-22.Successful treatment of solitary bone metastasis of non-small cell lung cancer with bevacizumab and hyperthermia. Rubovszky G, Nagy T, Gődény M, Szász A, Láng I.


  1. Clin Exp Metastasis. 2007;24(3):191-200.Novel hyperthermia for metastatic bone tumors with magnetic materials by generating an alternating electromagnetic field. Matsumine A, Kusuzaki K, Matsubara T, Shintani K, Satonaka H, Wakabayashi T, Miyazaki S, Morita K, Takegami K, Uchida A.



  1. Eur J Surg Oncol. 2013 Dec;39(12):1435-43. Peritoneal carcinomatosis treated with cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for advanced ovarian carcinoma: a French multicentre retrospective cohort study of 566 patients. Bakrin N, Bereder JM, Decullier E, Classe JM, Msika S, Lorimier G, Abboud K, Meeus P, Ferron G, Quenet F, Marchal F, Gouy S, Morice P, Pomel C, Pocard M, Guyon F, Porcheron J, Glehen O; FROGHI (FRench Oncologic and Gynecologic HIPEC) Group.


  1. Eur J Surg Oncol. 2013 Oct;39(10):1109-15. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for the treatment of advanced epithelial ovarian carcinoma: upfront therapy, at first recurrence, or later? Gonzalez Bayon L, Steiner MA, Vasquez Jimenez W, Asencio JM, Alvarez de Sierra P, Atahualpa Arenas F, Rodriguez del Campo J, Garcia Sabrido JL.


  1. Drug Metab Dispos. 2012 Dec;40(12):2365-73.Pharmacokinetics of pegylated liposomal doxorubicin administered by intraoperative hyperthermic intraperitoneal chemotherapy to patients with advanced ovarian cancer and peritoneal carcinomatosis. Salvatorelli E, De Tursi M, Menna P, Carella C, Massari R, Colasante A, Iacobelli S, Minotti G.


  1. Ann Surg Oncol. 2012 Dec;19(13):4052-8.Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for persistent and recurrent advanced ovarian carcinoma: a multicenter, prospective study of 246 patients. Bakrin N, Cotte E, Golfier F, Gilly FN, Freyer G, Helm W, Glehen O, Bereder JM.


  1. Anticancer Res. 2011 Aug;31(8):2675-7. Long term combination treatment with bevacizumab, pegylated liposomal doxorubicin and regional abdominal hyperthermia in platinum refractory ovarian cancer: a case report and review of the literature. Pietzner K, Schmuck RB, Fotopoulou C, Gellermann J, Ismaeel F, Cho CH, Kalden M, Sehouli J.


  1. Int J Hyperthermia. 2010;26(2):118-26.Regional abdominal hyperthermia combined with systemic chemotherapy for the treatment of patients with ovarian cancer relapse: Results of a pilot study. Fotopoulou C, Cho CH, Kraetschell R, Gellermann J, Wust P, Lichtenegger W, Sehouli J.



  1. Int J Hyperthermia. 2013;29(1):8-16.Gemcitabine and cisplatin combined with regional hyperthermia as second-line treatment in patients with gemcitabine-refractory advanced pancreatic cancer. Tschoep-Lechner KE, Milani V, Berger F, Dieterle N, Abdel-Rahman S, Salat C, Issels RD.


  1. Int J Hyperthermia. 2012;28(7):597-604.Phase II trial of combined regional hyperthermia and gemcitabine for locally advanced or metastatic pancreatic cancer. Ishikawa T, Kokura S, Sakamoto N, Ando T, Imamoto E, Hattori T, Oyamada H, Yoshinami N, Sakamoto M, Kitagawa K, Okumura Y, Yoshida N, Kamada K, Katada K, Uchiyama K, Handa O, Takagi T, Yasuda H, Sakagami J, Konishi H, Yagi N, Naito Y, Yoshikawa T.


  1. Strahlenther Onkol. 2011 Oct;187(10):619-25. Regional hyperthermia combined with chemoradiotherapy in primary or recurrent locally advanced pancreatic cancer : an open-label comparative cohort trial. Maluta S, Schaffer M, Pioli F, Dall'oglio S, Pasetto S, Schaffer PM, Weber B, Giri MG.



  1. J Clin Oncol. 2005 May 1;23(13):3079-85. Randomized trial of hyperthermia and radiation for superficial tumors. Jones EL, Oleson JR, Prosnitz LR, Samulski TV, Vujaskovic Z, Yu D, Sanders LL, Dewhirst MW.


  1. Int J Hyperthermia. 2013 Sep;29(6):551-7.Long-term follow-up of 163 consecutive patients treated with isolated limb perfusion for in-transit metastases of malignant melanoma. Olofsson R, Mattsson J, Lindnér P.



  1. Strahlenther Onkol. 2013 May;189(5):387-93. Effect of a combined surgery, re-irradiation and hyperthermia therapy on local control rate in radio-induced angiosarcoma of the chest wall. Linthorst M, van Geel AN, Baartman EA, Oei SB, Ghidey W, van Rhoon GC, van der Zee J


  1. Int J Hyperthermia. 2009 May;25(3):189-98. Radio hyperthermia for re-treatment of superficial tumours. Gabriele P, Ferrara T, Baiotto B, Garibaldi E, Marini PG, Penduzzu G, Giovannini V, Bardati F, Guiot



  1. Lancet Volume 355, Issue 9210, 1 April 2000, Pages 1119– Comparison of radiotherapy alone with radiotherapy plus hyperthermia in locally advanced pelvic tumours: a prospective, randomized, multicentric trial. Jacoba van der Zee, MDb,Prof Dionisio González, González MDa, Gerard C van Rhoon, PhDb, Jan DP van Dijk, PhDa, Wim LJ van Putten, MScc, Augustinus AM Hart, MScc, for the Dutch Deep Hyperthermia Group



  1. Lung Cancer. 2012 Jul;77(1):140-5. Re-irradiation plus regional hyperthermia for recurrent non-small cell lung cancer: a potential modality for inducing long-term survival in selected patients. Ohguri T, Imada H, Yahara K, Moon SD, Yamaguchi S, Yatera K, Mukae H, Hanagiri T, Tanaka F, Korogi Y.


  1. Zhongguo Fei Ai Za Zhi. 2011 Jul;14(7):593-7.Efficacy of radiofrequency hyperthermia combined with chemotherapy in treatment of malignant pericardial effusion caused by lung cancer. Luo P, Cao P, Yao Z.


  1. Int J Hyperthermia. 2011;27(1):27-32.The regimen of gemcitabine and cisplatin combined with radio frequency hyperthermia for advanced non-small cell lung cancer: a phase II study. Shen H, Li XD, Wu CP, Yin YM, Wang RS, Shu YQ.


  1. Zhongguo Fei Ai Za Zhi. 2010 Feb;13(2):132-5. BSD2000 deep hyperthermia combined with chemotherapy of PT regimen in patients with non-small cell lung cancer. Yang M, Zhao J, Wang Y.



  1. Int J Hyperthermia. 2009 Mar;25(2):160-7. Systemic chemotherapy using paclitaxel and carboplatin plus regional hyperthermia and hyperbaric oxygen treatment for non-small cell lung cancer with multiple pulmonary metastases: preliminary results.

Ohguri T, Imada H, Narisada H, Yahara K, Morioka T, Nakano K, Miyaguni Y, Korogi Y.


  1. Strahlenther Onkol. 2013 Dec 8. Salvage prostate HDR brachytherapy combined with interstitial hyperthermia for local recurrence after radiation therapy failure.

Kukiełka AM, Hetnał M, Dąbrowski T, Walasek T, Brandys P, Nahajowski D, Kudzia R, Dybek D, Reinfuss M.


  1. Int J Hyperthermia. 2010;26(8):765-74.Treatment for intermediate and high-risk prostate cancer: controversial issues and the role of hyperthermia. Maluta S, Dall'oglio S, Nadalini L.


  1. 2011 Feb 1;117(3):510-6. Hyperthermia combined with radiation for the treatment of locally advanced prostate cancer: long-term results from Dana-Farber Cancer Institute study 94-153. Hurwitz MD, Hansen JL, Prokopios-Davos S, Manola J, Wang Q, Bornstein BA, Hynynen K, Kaplan ID.


  1. Int J Hyperthermia. 2010;26(8):790-5.Magnetic nanoparticle hyperthermia for prostate cancer. Johannsen M, Thiesen B, Wust P, Jordan A.


  1. Eur Urol. 2007 Dec;52(6):1661-2. Editorial comment on: Thermotherapy of prostate cancer using magnetic nanoparticles: feasibility, imaging, and three-dimensional temperature distribution. Hurwitz M.


  1. Int J Hyperthermia. 2007 Aug;23(5):451-6.Conformal radiotherapy plus local hyperthermia in patients affected by locally advanced high risk prostate cancer: preliminary results of a prospective phase II study. Maluta S, Dall'Oglio S, Romano M, Marciai N, Pioli F, Giri MG, Benecchi PL, Comunale L, Porcaro AB.



  1. Strahlenther Onkol. 2013 Jun;189(6):482-5.Effect of concurrent chemotherapy and hyperthermia on outcome of preoperative radiotherapy of high-risk soft tissue sarcomas. Eckert F, Gani C, Kluba T, Mayer F, Kopp HG, Zips D, Bamberg M, Müller AC.


  1. Strahlenther Onkol. 2013 May;189(5):387-93. Effect of a combined surgery, re-irradiation and hyperthermia therapy on local control rate in radio-induced angiosarcoma of the chest wall. Linthorst M, van Geel AN, Baartman EA, Oei SB, Ghidey W, van Rhoon GC, van der Zee J.


  1. 2012 Jan 1;118(1):180-7.Reirradiation and hyperthermia for radiation-associated sarcoma. de Jong MA, Oldenborg S, Bing Oei S, Griesdoorn V, Kolff MW, Koning CC, van Tienhoven G.


  1. Curr Treat Options Oncol. 2011 Mar;12(1):12-20. Hyperthermia in soft tissue sarcoma. Lindner LH, Issels RD.


  1. Lancet Oncology 2010;11(6): 561-570. Neo-adjuvant chemotherapy alone or with regional hyperthermia for localized high-risk- soft tissue sarcoma: a randomized phase 3 multicentre study. RD Issels et al.


  1. Gan To Kagaku Ryoho. 2013 Nov;40(12):1596-9.The effect of immunotherapy and hyperthermia on patients with advanced or recurrent breast cancer. Takeda T, Takeda T, Etani M, Kobayashi S, Takeda H.


  1. Radiother Oncol. 2013 Nov;109(2):188-93. Re-irradiation and hyperthermia after surgery for recurrent breast cancer. Linthorst M, van Geel AN, Baaijens M, Ameziane A, Ghidey W, van Rhoon GC, van der Zee J.



  1. Case Rep Oncol. 2012 Sep;5(3):520-3. Superficial Hyperthermia plus External Beam Radiation in the Palliation of Locally Progressive Chemoradiation-Resistant Breast Cancer. Heese C, Lavagnini P, Mills P, Lewis M, Markman M.


  1. Int J Hyperthermia. 2012;28(7):583-90. Simultaneous radiotherapy and superficial hyperthermia for high-risk breast carcinoma: a randomised comparison of treatment sequelae in heated versus non-heated sectors of the chest wall hyperthermia.

Varma S, Myerson R, Moros E, Taylor M, Straube W, Zoberi I.


  1. Int J Hyperthermia. 2012;28(3):267-77. The tolerance of reirradiation and hyperthermia in breast cancer patients with reconstructions. Linthorst M, van Rhoon GC, van Geel AN, Baaijens M, Ghidey W, Broekmeyer-Reurink MP, van der Zee J.



  1. Radiother Oncol. 2010 Dec;97(3):535-40. Durable palliation of breast cancer chest wall recurrence with radiation therapy, hyperthermia, and chemotherapy.

Zagar TM, Higgins KA, Miles EF, Vujaskovic Z, Dewhirst MW, Clough RW, Prosnitz LR, Jones EL.


  1. Int J Hyperthermia. 2010;26(7):638-48. Reirradiation combined with hyperthermia in breast cancer recurrences: overview of experience in Erasmus MC. Van Der Zee J, De Bruijne M, Mens JW, Ameziane A, Broekmeyer-Reurink MP, Drizdal T, Linthorst M, Van Rhoon GC.


  1. Int J Hyperthermia. 2010;26(7):611. Breast cancer. Introduction. Jones EL.


  1. Int J Hyperthermia. 2013;29(2):156-67. Surgery combined with intraoperative hyperthermic intraperitoneal chemotherapy (IHIC) for gastric cancer: a systematic review and meta-analysis of randomised controlled trials. Mi DH, Li Z, Yang KH, Cao N, Lethaby A, Tian JH, Santesso N, Ma B, Chen YL, Liu YL.


  1. BMC Cancer. 2012 Nov 16;12:526. Benefits of hyperthermic intraperitoneal chemotherapy for patients with serosal invasion in gastric cancer: a meta-analysis of the randomized controlled trials. Sun J, Song Y, Wang Z, Gao P, Chen X, Xu Y, Liang J, Xu H.



  1. Int J Hyperthermia. 2012;28(8):735-41. Whole-body hyperthermia combined with hyperthermic intraperitoneal chemotherapy for the treatment of stage IV advanced gastric cancer. Zhao C, Dai C, Chen X.



  1. Ann Surg Oncol. 2011 Jun;18(6):1575-81.Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy improves survival of patients with peritoneal carcinomatosis from gastric cancer: final results of a phase III randomized clinical trial. Yang XJ, Huang CQ, Suo T, Mei LJ, Yang GL, Cheng FL, Zhou YF, Xiong B, Yonemura Y, Li Y.


  1. Lancet Oncol. 2013 Aug;14(9):843-52. Regional deep hyperthermia for salvage treatment of children and adolescents with refractory or recurrent non-testicular malignant germ-cell tumours: an open-label, non-randomised, single-institution, phase 2 study.


  1. Wessalowski R, Schneider DT, Mils O, Friemann V, Kyrillopoulou O, Schaper J, Matuschek C, Rothe K, Leuschner I, Willers R, Schönberger S, Göbel U, Calaminus G; MAKEI study group.


  1. 1995 Feb 15;75(4):908-13. Hyperthermia and radiation therapy for inoperable or recurrent parotid carcinoma. A phase I/II study. Gabriele P, Amichetti M, Orecchia R, Valdagni R.


  1. Biomed Res Int. 2013;2013:262313. Hyperthermia as adjunct to intravesical chemotherapy for bladder cancer. Owusu RA, Abern MR, Inman BA.


  1. Int J Hyperthermia. 2013 Dec;29(8):835-44. Magnetic fluid hyperthermia for bladder cancer: a preclinical dosimetry study. Oliveira TR, Stauffer PR, Lee CT, Landon CD, Etienne W, Ashcraft KA, McNerny KL, Mashal A, Nouls J, Maccarini PF, Beyer WF Jr, Inman B, Dewhirst MW



  1. J Endourol. 2013 Sep 2. Novel multi-sensor probe for monitoring bladder temperature during loco-regional chemo-hyperthermia for non-muscle invasive bladder cancer: technical feasibility study. Cordeiro Feijoo ER, Geijsen DE, Zum Vörde Sive Vörding PJ, Schooneveldt G, Sijbrands J, Hulshof MC, De La Rosette J, de Reijke TM, Crezee H.



  1. 2013 Jul 10;80(2):112-9. Role of the combined regimen with local chemotherapy and Mw-induced hyperthermia for non-muscle invasive bladder cancer management. A systematic review. [Article in Italian] Colombo R, Moschini M.



  1. Eur Urol. 2011 Jul;60(1):81-93. The role of a combined regimen with intravesical chemotherapy and hyperthermia in the management of non-muscle-invasive bladder cancer: a systematic review. Lammers RJ, Witjes JA, Inman BA, Leibovitch I, Laufer M, Nativ O, Colombo R.


  1. BJU Int. 2011 May;107(10):1685; Long-term outcomes of a randomized controlled trial comparing thermochemotherapy with mitomycin-C alone as adjuvant treatment for non-muscle-invasive bladder cancer (NMIBC). Neulander EZ, Kaneti J.



  1. Oncology (Williston Park). 2010 Nov 15;24(12):1149-55. Hyperthermia as a treatment for bladder cancer. Rampersaud EN, Vujaskovic Z, Inman BA.


  1. BJU Int. 2011 Mar;107(6):912-8. Long-term outcomes of a randomized controlled trial comparing thermochemotherapy with mitomycin-C alone as adjuvant treatment for non-muscle-invasive bladder cancer (NMIBC). Colombo R, Salonia A, Leib Z, Pavone-Macaluso M, Engelstein D.




  1. Strahlenther Onkol. 2006 Jun;182(6):318-24.Concurrent radiochemotherapy of locally recurrent or advanced sarcomas of the uterus. Kortmann B, Reimer T, Gerber B, Klautke G, Fietkau R.





  1. Int J Radiat Oncol Biol Phys. 1992;23(1):189-99. Interstitial microwave hyperthermia and brachytherapy for malignancies of the vulva and vagina. I: Design and testing of a modified intracavitary obturator. Ryan TP, Taylor JH, Coughlin CT.


  1. Curr Opin Obstet Gynecol. 2010 Feb;22(1):9-14. Use of combined radiation and hyperthermia for gynecological cancer. Franckena M, van der Zee J.


  1. Radiother Oncol. 2008 Aug;88(2):286-7. Hyperthermia to improve results in vaginal cancer.Van der Zee J, Kleynen CE, Nuyttens JJ, Ansink AC.



  1. Eur J Obstet Gynecol Reprod Biol. 2007 Jul;133(1):100-4. Concomitant radiotherapy and hyperthermia for primary carcinoma of the vagina: a cohort study. Aktas M, de Jong D, Nuyttens JJ, van der Zee J, Wielheesen DH, Batman E, Burger CW, Ansink AC.


The Kadota Fund International Forum 2004 Report


1Erasmus MC – Daniel den Hoed Cancer Center, Rotterdam, the Netherlands, 2Duke University Medical Center,

Durham, USA, 3AINO Hospital, Osaka, Japan, and 4Kyoto University, Kyoto, Japan

(tradotto da S. Maluta)




Clinical group consensus


J.M.C. Bull, University of Texas, Houston, USA

  1. Harima, Kansai Medical University, Osaka, Japan,

N.G. Huilgol,Dr. Balabhai Nanavati Hospital, Mumbai, India,

M.D. Hurwitz, Harvard Medical School, Boston, USA,

C.K. Lee, University of Minnesota Medical Center,Minneapolis, USA,

  1. Maluta, Oncological Regional Center of University Hospital of Verona, Italy,
  2. Osinsky, Institute of Experimental Pathology, Oncology and Radiobiology, Kiev, Ukraine,

V.V. Ostapenko, Shouseikai Nishide Hospital, Osaka, Japan,

  1. Sahinbas, University of Witten-Herdecke, Bochum,Germany,
  2. Terashima, Kyushu University, Fukuoka, Japan,
  3. U, Rex Healthcare Cancer Center, Raleigh, USA,
  4. Ueda, Nagoya Prostatic Center Nagoya, Japan.




L’ipertermia è un incremento di temperature al di sopra dei livelli fisiologici con l’obiettivo di acquisire un vantaggio terapeutico. Essa è generalmente definita come un innalzamento nel range di 39 – 45 °C. temperature più elevate sono impiegate nelle termo ablazioni. Al Kadota meeting parteciparono solo clinici che usano l’ipertermia classica e pertanto questo rapporto è riservato all’uso della temperatura nel range di 39-45°C. l’uso di temperature elevate per curare il cancro è stato ben documentato da molti anni [1].

Il primo congresso internazionale venne tenuto a Washington DC nel 1975 che stimolò molto interesse ed entusiasmi che successivamente si assopirono dopo che i primi studi randomizzati effettuati negli USA fornirono risultati deludenti.

Comunque risultati più recenti di alcuni studi randomizzati hanno dimostrato un grande miglioramento nei risultati ottenuti sommando l’ipertermia alla radio o chemioterapia ,a patto che vengano utilizzati dei sistemi di riscaldamento adeguati (cosa che non era avvenuta negli studi precedenti).

In questo rapporto viene raccolto sinteticamente il consenso dei partecipanti al Kadota Forum di Osaka sugli aspetti clinici dell’ipertermia e vengono discussi i problemi connessi all’accettazione di questa metodica terapeutica

Metodi per aumentare la temperatura

L’ipertermia clinica si ottiene esponendo i tessuti a sorgenti conduttive di calore, o a radiazioni non ionizzanti (onde elettromagnetiche o ultrasuoni). Sebbene queste metodiche depositino il calore nei tessuti con meccanismi fisici diversi essi presentano degli effetti similari in quanto sono sensibili alle diverse proprietà dei tessuti, al flusso ematico e tutte presentano problemi di accoppiamento con i tessuti. L’ipertermia può essere somministrata invasivamente o non usando applicatori esterni; essa può essere data localmente, con perfusione o come ipertermia whole body (figura 1).

Ipertermia locale

Scopo dell’ipertermia locale è raggiungere la dose termica ottimale nei tessuti tumorali senza superare I limiti di tolleranza dei tessuti sani adiacenti. Essa può essere applicata dall’esterno o per via intraluminale (esofago, vescica, vagina) o per via interstiziale (tumori cerebrali, tumore mammario, tumori della cute).

L’energia elettromagnetica è diretta verso il volume da irradiare e la possibilità che esso venga adeguatamente riscaldato dipende dalle sue caratteristiche fisiche e dal tipo di applicatore [2].

I metodi per applicare l’ipertermia dall’esterno si dividono in superficiali e profonde. Per il riscaldamento in profondità l’energia viene diretta attraverso le varie parti del corpo nel volume interessato all’interno del corpo stesso. La distribuzione dell’energia all’interno dei tessuti è strettamente dipendente dalle caratteristiche tissutali e pertanto risulta non omogenea. La variabilità della distribuzione della temperatura dipende non solo dalla distribuzione dell’energia ma anche dalle caratteristiche termiche dei tessuti e dalla circolazione del sangue. Durante l’ipertermia locale la temperatura sistemica può aumentare in funzione del volume riscaldato e delle misure prese per impedire al paziente di perdere energia.

Ipertermia perfusionale


La perfusione di un arto, un organo o di una cavità anatomica con fluidi riscaldati produce un riscaldamento regionale [3, 4]. Quando questo approccio è applicato sugli arti e senza un agente citotossico la temperatura può tranquillamente salire sino ai 43°C per la durata di 2 ore. Se usata in combinazione con farmaci citotossici (chemioterapia) la temperatura deve essere aggiustata per evitare una inaccettabile tossicità.


Ipertermia Whole-body


Vari metodi sono stati impiegati. Una comune caratteristica è l’introduzione di energia nel corpo minimizzandone nello stesso tempo la perdita. L’aumento di temperatura è solitamente limitato a 41.8-42°C.

L’esperienza ha insegnato questae procedure, che richiedono una sedazione profonda, sono ben tollerate [5, 6].Una nuova procedura consiste nell’aumentare la temperatura sino a circa 40°C per un lungo periodo in combinazione con citochine o farmaci citotossici. Questa sembra dare un indice terapeutico maggiore rispetto al trattamento breve con temperature al massimo livello di tolleranza [7].