Abstract
The problem with the application of conventional hyperthermia in oncology is firmly connected to the dose definition, which conventionally uses the concept of the homogeneous (isothermal) temperature of the target. Its imprecise control and complex evaluation is the primary barrier to the extensive clinical applications. The aim of this study was to show the basis of the problems of the misleading dose concept. A clear clarification of the proper dose concept must begin with the description of the limitations of the present doses in conventional hyperthermia applications. The surmounting of the limits the dose of oncologic hyperthermia has to be based on the applicability of the Eyring transition state theory on thermal effects. In order to avoid the countereffects of thermal homeostasis, the use of precise heating on the nanoscale with highly efficient energy delivery is recommended. The nano-scale heating allows for an energy-based dose to control the process. The main aspects of the method are the following: i) It is not isothermal (no homogeneous heating); ii) malignant cells are heated selectively; and iii) it employs high heating efficacy, with less energy loss. The applied rigorous thermodynamical considerations show the proper terminology and dose concept of hyperthermia, which is based on the energy-absorption (such as in the case of ionizing radiation) instead of the temperature-based ideas. On the whole, according to the present study, the appropriate dose in oncological hyperthermia must use an energy-based concept, as it is well-known in all the ionizing radiation therapies. We propose the use of Gy (J/kg) in cases of non-ionizing radiation (hyperthermia) as well.
Highlights
Hyperthermia therapy in oncologyHyperthermia is an ancient method; it was the very first medical treatment in human medicine
This approach currently has no widespread applications and is on the periphery of the medical therapies. This contradiction characterizes the history of hyperthermia in medicine
The use of hyperthermia as a therapy has various stumbling blocks as the effect caused by the absorbed heat is too complex; the applied, absorbed energy is usually depleted non‐homogeneously, and the intricacy of biological processes modifies the intended impact of application
Summary
Hyperthermia is an ancient method; it was the very first medical treatment in human medicine. The correct dose (absorbed energy, AE) which transforms Eq[12] scientifically correct and optimal [Equation 14]: Generally, oncological hyperthermia is the result of energy absorption, which changes the target via chemical, structural, mechanical and electromagnetic variations (the induced anthropogenic fever therapies, or inflammatory local heating by biological effects are not discussed ). Due to the high value of temperature in K, but its relatively small difference from Tc in this case [Equation 20]: The Arrhenius graph gives different time doses for the different points of the target (due to its non‐homogeneous structure); this promotes chemical reactions and lowers the activation energy [59]. This dose is appropriate for the complex non‐ionizing radiation process and unites the complete radiation field (together with ionizing radiation) around the same dose control
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