Regional hyperthermia: new standard for soft-tissue sarcomas?

Abstract

In this issue of The Lancet Oncology, Issels and colleagues 1 Issels RD Lindner LH Verweij J et al. Neo-adjuvant chemotherapy alone or with regional hyperthermia for localised high-risk soft tissue sarcoma: a randomised phase 3 multicentre study. Lancet Oncol. 2010; 11: 561-570 Summary Full Text Full Text PDF PubMed Scopus (476) Google Scholar describe a large, randomised phase 3 study assessing the effects of local hyperthermia in addition to chemotherapy and local therapy (surgery whenever possible with or without radiation) in a group of selected patients with intermediate or high-grade soft-tissue sarcomas greater than 5 cm, and deep. 1 Issels RD Lindner LH Verweij J et al. Neo-adjuvant chemotherapy alone or with regional hyperthermia for localised high-risk soft tissue sarcoma: a randomised phase 3 multicentre study. Lancet Oncol. 2010; 11: 561-570 Summary Full Text Full Text PDF PubMed Scopus (476) Google Scholar The trial was a multicentre study, although three institutions with major previous experience of using hyperthermia contributed 310 of the 341 patients, with the remainder distributed among another six centres. Including this small subset of patients had no effect on the results, and the reader is left to wonder whether the findings of the study could be extrapolated for widespread use or whether the technique should be limited to centres of expertise. If hyperthermia is to be considered a standard treatment, studies of more than 31 patients in six centres are needed. Neo-adjuvant chemotherapy alone or with regional hyperthermia for localised high-risk soft-tissue sarcoma: a randomised phase 3 multicentre studyTo our knowledge, this is the first randomised phase 3 trial to show that regional hyperthermia increases the benefit of chemotherapy. Adding regional hyperthermia to chemotherapy is a new effective treatment strategy for patients with high-risk STS, including STS with an abdominal or retroperitoneal location. Full-Text PDF