Pianficazione del trattamento di Ipertermia

Il presente articolo mette in evidenza come l'ipertermia in oncologia sia una ottima metodica coadiuvante sinergica rispetto a chemioterapia e/o radioterapia e soprattutto come un piano di trattamento adeguato e delle apparecchiature adeguate facciano la differenza rispetto all'andamento clinico del Paziente.

Radiat Oncol. 2015 Sep 17;10(1):196. doi: 10.1186/s13014-015-0503-8.

Current state of the art of regional hyperthermia treatment planning: a review.

Kok HP1, Wust P2, Stauffer PR3, Bardati F4, van Rhoon GC5, Crezee J6.

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Abstract

Locoregional hyperthermia, i.e. increasing the tumor temperature to 40-45 °C using an external heating device, is a very effective radio and chemosensitizer, which significantly improves clinical outcome. There is a clear thermal dose-effect relation, but the pursued optimal thermal dose of 43 °C for 1 h can often not be realized due to treatment limiting hot spots in normal tissue. Modern heating devices have a large number of independent antennas, which provides flexible power steering to optimize tumor heating and minimize hot spots, but manual selection of optimal settings is difficult. Treatment planning is a very valuable tool to improve locoregional heating. This paper reviews the developments in treatment planning software for tissue segmentation, electromagnetic field calculations, thermal modeling and optimization techniques. Over the last decade, simulation tools have become more advanced. On-line use has become possible by implementing algorithms on the graphical processing unit, which allows real-time computations. The number of applications using treatment planning is increasing rapidly and moving on from retrospective analyses towards assisting prospective clinical treatment strategies. Some clinically relevant applications will be discussed.