I benefici della ipertermia nel cancro del pancreas

L'articolo tratta di una review pubblicata su International Journal of Hyperthermia che evidenzia il beneficio dell'aggiunta di ipertermia a chemioterapia e/o radioterapia nelle neoplasie del pancreas.

 

 

 Dr. Carlo Pastore

 

 

Int J Hyperthermia. 2017 Nov 23:1-11. doi: 10.1080/02656736.2017.1401126. [Epub ahead of print]

The clinical benefit of hyperthermia in pancreatic cancer: a systematic review.

van der Horst A1, Versteijne E1, Besselink MGH2, Daams JG3, Bulle EB1, Bijlsma MF4, Wilmink JW5, van Delden OM6, van Hooft JE7, Franken NAP4, van Laarhoven HWM5, Crezee J1, van Tienhoven G1.

Author information

Abstract

OBJECTIVE:

In pancreatic cancer, which is therapy resistant due to its hypoxic microenvironment, hyperthermia may enhance the effect of radio(chemo)therapy. The aim of this systematic review is to investigate the validity of the hypothesis that hyperthermia added to radiotherapy and/or chemotherapy improves treatment outcome for pancreatic cancer patients.

METHODS AND MATERIALS:

We searched MEDLINE and Embase, supplemented by handsearching, for clinical studies involving hyperthermia in pancreatic cancer patients. The quality of studies was evaluated using the Oxford Centre for Evidence-Based Medicine levels of evidence. Primary outcome was treatment efficacy; we calculated overall response rate and the weighted estimate of the population median overall survival (mp) and compared these between hyperthermia and control cohorts.

RESULTS:

Overall, 14 studies were included, with 395 patients with locally advanced and/or metastatic pancreatic cancer of whom 248 received hyperthermia. Patients were treated with regional (n?=?189), intraoperative (n?=?39) or whole-body hyperthermia (n?=?20), combined with chemotherapy, radiotherapy or both. Quality of the studies was low, with level of evidence 3 (five studies) and 4. The six studies including a control group showed a longer mp in the hyperthermia groups than in the control groups (11.7 vs. 5.6?months). Overall response rate, reported in three studies with a control group, was also better for the hyperthermia groups (43.9% vs. 35.3%).

CONCLUSIONS:

Hyperthermia, when added to chemotherapy and/or radiotherapy, may positively affect treatment outcome for patients with pancreatic cancer. However, the quality of the reviewed studies was limited and future randomised controlled trials are needed to establish efficacy.