Hyperthermia--its actual role in radiation oncology. Part II: Clinical fundamentals and results in superficial tumors.

This overview summarizes the most important clinical fundamentals to implement combined hyperthermia (HT) and radiotherapy (RT) in clinical trials and reviews clinical HT-RT data obtained in superficial and medium depth tumors treated with external heating devices. In the first part we discuss the following clinical fundamentals: selection of appropriate clinical sites for HT-RT studies, selection of suitable HT-devices, principle design of clinical HT-RT studies, requirements for treatment prescription, relevant treatment endpoints, definition and assessment of a thermal enhancement ratio (TER) and therapeutic gain factor (TGF), impact of prognostic parameters on treatment stratification and statistical evaluation. In the second part we review and discuss clinical results of thermoradiotherapy (HT-RT) for advanced breast carcinoma, recurrent breast cancer, advanced head and neck tumors, cervical neck node metastases, malignant melanomas and residual microscopic disease. In addition, clinical results of pilot studies are reviewed, which have applied a triple modality approach of thermo-radiochemotherapy (HRC) for various tumors. Finally, possible future perspectives of clinical HT-RT research are outlined.