**Author details**

Ragab Hani Donkol *Department of Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt Aseer Central Hospital, Abha, Saudi Arabia* 

Ahmed Al Nammi *Aseer Central Hospital, Abha, Saudi Arabia* 

### **9. References**

166 Hyperthermia

**7. Heat-activated drug delivery** 

**8. Conclusions** 

**Author details** 

Ragab Hani Donkol

Ahmed Al Nammi

*Aseer Central Hospital, Abha, Saudi Arabia* 

*Aseer Central Hospital, Abha, Saudi Arabia* 

side effects. It has been demonstrated that hyperthermia also has an anti-angiogenic action and an immunotherapeutic role, due to thermal shock proteins, which are produced by

The immunotherapeutic role of hyperthermia is not yet completely understood. Especially, the effects on natural killer (NK) cell cytotoxicity against tumor cell targets have not been fully demonstrated. At treatment temperatures above 40 °C, both enhancing and inhibitory effects of cytotoxic activity of NK cells against tumor cells have been reported. In particular, an enhancement of human NK cytotoxicity against tumor cell targets has been demonstrated using a temperature of 39.5 °C10. Data in the literature indicate a strong potential for heat-induced enhancement of NK cell activity in mediating the improved clinical response. A better understanding in this field should be achieved in order to maximize the clinical benefits obtained by using hyperthermia for cancer therapy (68).

An exciting new generation of clinical trials is now harnessing drug-containing thermosensitive liposomes, and other nanoparticle drug carriers, that release contained chemotherapy agents upon heating above ~40 °C. Combined with localized heating methods as described above, this allows for targeted chemotherapy delivery to tumors. Thermal ablation or hyperthermia can be combined with heat-activated drug carriers to selectively deposit chemotherapy in the heated area. Initial clinical trial results suggest patient benefits from this combination and thus there is

Hyperthermia, thanks to the improved systems for achieving an optimal distribution of heat inside the tumor and precise and noninvasive thermometry, is today an important treatment modality in the treatment of cancer, and its results are strongly supported by criteria of evidence-based medicine. Hyperthermia is an important treatment modality in cancer treatment and its results are strongly supported by criteria of evidence-based medicine. Hyperthermia is a therapeutic modality that, employing nonionizing radiations, can be used not only by radiation oncologists but also by clinical oncologists. Its addition to radiotherapy with or without chemotherapy is important when it is necessary to treat advanced or high-risk tumors, or to retreat a relapse in a pre-irradiated area. Hyperthermia

appears to be the fourth pillar besides surgery, radiotherapy and chemotherapy.

*Department of Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt* 

considerable excitement among members of our Society in this approach.

stressed tumor cells. Finally, hyperthermia substains the action of genic therapy (67).


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**Chapter 6** 

© 2013 Okhai and Smith, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

and reproduction in any medium, provided the original work is properly cited.

**Principles and Application of RF System for** 

In recent times, different strategies for thermal ablation therapy have been in use. They include radiofrequency ablation, cryoablation therapy, laser ablation therapy, microwave ablation and high intensity focused ultrasound ablation, among others. *Radiofrequency ablation (RFA)* is used to destroy pathological tissue by inducing tissue necrosis through the heating of targeted tissue [1]. While ablation is currently used in the treatment of different diseases, tumour ablation is considered here, i.e. the treatment of cancerous tumours. Apart from RFA, thermal ablation therapy involves other strategies employed in the destruction of cancerous tumours. *Cryoablation therapy (or cryotherapy)* uses liquid nitrogen (or the expansion of argon gas) to freeze and kill abnormal tissue. After numbing the tissue around the mass, a cryoprobe, which is shaped like a large needle, is inserted into the middle of the lesion. An ice ball forms at the tip of the probe and continues to grow until the images confirm that the entire tumour has been engulfed, killing the tissue [2], [3]. The whole process involved in cryotherapy takes about 10 – 20 minutes to complete. The temperature and duration of freezing necessary to induce complete killing and necrosis are based on numerous in vivo and in vitro animal studies, some of which have been reviewed by Gage & Baust [4]. Generally, it has been accepted that a minimum freezing temperature of -40oC must be reached for at least 3 minutes for complete eradication of the tumour [5]. A rapid freeze followed by a slow thaw is the most damaging to cells, and a minimum of two freezethaw cycles (freeze-thaw-freeze-thaw) was necessary for effective cryonecrosis to take place than a single cycle [6]. The cost of a cryoablation unit ranges upwards from \$190,000, and each multi-use cryoprobe costs approximately \$3,750 [7]. *Laser Ablation (or interstitial laser photocoagulation)* uses a highly concentrated beam of light to penetrate the cancerous tissue. The laser energy is emitted from an optical fibre placed within a needle positioned at the centre of the tumour using either stereotactic guidance or Magnetic Resonance Imaging (MRI) [8], [9]. Two methods for delivery of light have been described to produce larger

**Hyperthermia Therapy** 

Timothy A. Okhai and Cedric J. Smith

http://dx.doi.org/10.5772/55108

**1. Introduction** 

Additional information is available at the end of the chapter

