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R Issels

Publications and source records attributed to R Issels.

27 records · Page 2Linked to original sources

[Regional deep hyperthermia of sarcoma for improving local tumor control].

48 patients with advanced sarcomas were treated with regional hyperthermia (RHT) and systemic chemotherapy (ifosfamide/VP-16). 92% of the patients had been pretreated before entering the study. Pretreatment consisted of chemotherapy (33/48), surgery (9/48) or surgery plus irradiation (2/48). Following the conventional treatment, the patients had either relapsed (30/48) or had shown progressive disease (14/48) at the primary site with or without metastases. In 43 patients the overall response rate [5 complete responders (CR) and 6 partial responders (PR)] was 26%, 17 patients revealed no change (NC) and 15 patients showed local tumor progression (PD). A significant correlation of tumor response (responders [CR + PR] versus non-responders [PD]) with intratumoral averaged temperatures could be observed.

Abdominal Neoplasms↗

[Hyperthermia in cancer research. Historical development, current status of research, future perspectives and differentiation from alternative medical procedures].

Already at the beginning of the 19th century first clinical trials with systemically induced fever were performed on malignant tumors. An intensified research in thermobiology in the sixties of this century gave the rationale for using this modality for cancer treatment. Clinical use of hyperthermia in combination with radiation or chemotherapy begun in the mid of the seventies when a better technique for selective heating of the tumor was used. In the technical development the problem of heating deep-seated tumors was mainly solved. Temperature measurements of the tumor and surrounding tissues are performed with specialized thermometry systems using thin implanted catheters to measure inside the body. 1986 a pilot study was initiated at the Medical Clinic III of the Klinikum Grosshadern to study the effects of regional hyperthermia combined with systemic chemotherapy. This study is aimed on feasibility, toxicity, and tumor response.

Abdominal Neoplasms↗

A new method of investigating the efficacy of regional thermotherapy in subcutaneous xenografts of nude mice.

A new method of investigating the efficacy of regional thermotherapy in subcutaneous xenografts of nude mice is reported. The use of high frequency hyperthermia was well tolerated by the sensitive animals and allowed an exact continuous temperature measurement in different tumor regions. The interstitial procedure in this model could be the best approach for later clinical use in urology, e.g. for prostate treatment and is an alternative to the transrectal hyperthermia application.

Animals↗

[Operability of primary inoperable pelvic tumors by preoperative regional hyperthermia in combination with systemic chemotherapy exemplified by Ewing's sarcoma].

Failure of local tumor control is of critical importance in the clinical management of large pelvic tumors. For bulky sarcomas of the pelvis a new treatment strategy could be of importance in the future using preoperative regional hyperthermia combined with systemic chemotherapy. In our case history of a patient with unresectable Ewing sarcoma of the pelvis no tumor response could be observed during multi-drug chemotherapy alone. However, after treatment with regional hyperthermia combined with systemic chemotherapy, the tumor mass became resectable and was separated from the adjacent tissue by a fibrotic pseudocapsule. Histological evaluation of the tumor tissue showed a complete change of the pattern.

Adolescent↗

[Regional hyperthermia with systemic chemotherapy in children and adolescents: feasibility and clinical follow-up of 34 intensively pretreated patients with prognostically unfavorable tumor diseases].

Temperature elevation for a few degrees (degrees C) increases significantly the cytotoxicity of several antineoplastic drugs under experimental conditions. An isolated elevation of the tumour temperature, which is possible since a few years, might be able to improve local tumour control without increasing the systemic toxicity. This study was performed to examine the feasibility of regional hyperthermia with systemic chemotherapy in pediatric patients. The special interests were the level of temperatures that could be achieved as well as the degree of toxicity and undesired side effects. Furthermore there was some hope to attain local tumour control in cases with very poor prognosis. 34 patients up to 18 years were treated in Munich and Essen until the end of 1992. 21 suffered of local relapse, in 11 cases it was the 2nd up to the 7th relapse. In another 11 cases the indication for the combined treatment was tumour progress or non-response to previous therapy. 33 patients were pretreated by aggressive chemotherapy, 20 patients had received radiotherapy before. In 28 cases the tumour was located in the pelvis. The heating device that we use is commercially available. It is based on external electromagnetic radiation which induces heat by absorption within the tissue. Since the temperature distribution inside the tumours is very heterogeneous thermometry is necessary which can only be performed invasively. For this sake we use closed tip catheters which are inserted into the tumour by puncture or surgically. The catheters remain in place for the whole treatment duration of several weeks. Chemotherapy was performed in treatment cycles (3.4/patient) mainly using etoposide, ifosfamide, and carboplatin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

MR-imaging changes of musculoskeletal soft-tissue sarcomas associated with neoadjuvant chemotherapy and hyperthermia.

PURPOSE: To evaluate early changes in musculoskeletal soft-tissue sarcomas under neoadjuvant chemotherapy combined with regional hyperthermia (RHT). PATIENTS AND METHODS: Nineteen consecutive patients with high-grade soft-tissue sarcomas of the musculoskeletal system were treated with neoadjuvant chemotherapy combined with RHT. Patients were imaged, using a high field MR-scanner, before onset of therapy, immediately after one and after four cycles of therapy. The images were evaluated for volume reduction and development of tumour necrosis. In addition, side effects such as surrounding soft-tissue oedema, bleeding and muscle or bone marrow necrosis were analysed. RESULTS: Tumour volume reduction was significant after the completion of neoadjuvant therapy (mean 49%, range 5-91%; (p < 0.001). Extent of tumour necrosis was also significantly different before (mean 22%) and after therapy (mean 58%, p < 0.001). Three patients showed strong tumour necrosis already after one cycle of treatment. Tumour volume reduction was not associated with the extent of pre-existing necrosis or necrosis development. The extent of tumour volume before start of therapy did not affect volume reduction or necrosis induction after therapy. Reduction of tumour oedema was significant after therapy (p < 0.001). No side effects were observed during thermochemotherapy. CONCLUSION: Neoadjuvant chemotherapy combined with RHT resulted in significant tumour volume reduction and induction of tumour necrosis, which can be detected early and monitored closely with MRI.

Adult↗