Local recurrence of breast cancer (LRBC)

Local recurrence of breast cancer is frequently a therapeutic challenge. In case of pre-irradiation, the option of an effective tumour control by reirradiation is limited by the risk of cumulative radiotoxicity. These heavily pretreated patients are often also resistant against systemic therapies as chemo- and hormonetherapy, or the side-effects of these therapies must be weighed against the limited anti-tumour effects that can be expected.

In 2005, Jones et al. published a randomised study of HT/RT compared to RT alone in superficial tumours. The CR rate in the combined HT/RT group was 66% compared to 42% in the RT group alone. A significantly higher benefit was shown in patients who had previously been irradiated: 68% compared to 28%.

A recent Systematic Review and Meta-Analysis published by Datta N et al. in the International Journal of Radiation Oncology ((Vol. 94, No. 5, pp. 1073-1087, 2016) showed the efficacy of the combined HT/RT in the treatment of LRBC proven by randomized and single-arm clinical studies. In most of the studies the CR rate of pre-irradiated LRBC was between 60 and 70%.

Malignant melanoma

Overgaard et al. showed the efficacy of combined HT/RT in a randomised study with 134 lesions in 70 patients in Lancet in 1995. The tumour control over a period of two years was 46% in the combined group compared to 28% in the group treated with radiotherapy alone. This randomised study confirmed the positive results from previous single-arm studies and retrospective analyses.

The European Dermatological Guideline recommends the addition of hyperthermia to radiotherapy of inoperable melanoma lesion in case of large extension.

Other superficial tumors, skin mets of various tumours

In case of rare superficial tumor entities, such as vulva carcinoma, radioangiosarcoma, Merkle-cell carcinoma as well as inoperable skin mets of various tumour entities, the combined hyperthermia/radiotherapy might be considered in singular therapy decisions.