Regional hyperthermia in high-risk soft tissue sarcomas.

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Curr Opin Oncol. 2008 Jul;20(4):438-43.

Regional hyperthermia in high-risk soft tissue sarcomas.

Issels RD.
Hospital Medical Center Grosshadern, Medical Clinic III and Helmholtz
Zentrum münchen - German Research Center for Environmetal Health,
Munich, Germany.

On the basis of the definition of high-risk soft tissue
sarcomas and prognostic factors, the most recent developments of
preoperative treatment strategies with special emphasis on regional
hyperthermia combined chemotherapy are reviewed.
most important prognostic factors (e.g. size, grade, depth and
resection margins) for localized soft tissue sarcomas have been defined
to predict the probability of sarcoma-specific death providing a useful
tool for patient stratification and clinical trial eligibility
determination that are also relevant in the outcome of paediatric
patients with adult type soft tissue sarcomas. Clinical research on
innovative preoperative treatment strategies has essentially focused on
the combination of preoperative radiochemotherapy or chemotherapy
alone, but unfortunately the reported results are based upon
retrospective analysis or nonrandomized phase II studies with small
sample size. For the use of regional hyperthermia (RHT) therapy, phase
II studies have advocated a possible benefit of the use of regional
hyperthermia in combination with chemotherapy targeting the heating
field to the region of tumour burden. The preliminary results of a
completed European Organization for Research and Treatment of
Cancer-European Society of Hyperthermic Oncology intergroup randomized
phase III trial for the most common types of adult high-risk soft
tissue sarcomas demonstrate a significant benefit in the clinical
outcome of patients receiving regional hyperthermia therapy.
Regional hyperthermia combined with preoperative and postoperative
chemotherapy offers a new appropriate treatment option for high-risk
soft tissue sarcomas.