Skip to main content
Log in

Treatment of malignant brain tumors with focused ultrasound hyperthermia and radiation: results of a phase I trial

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Summary

Hyperthermia delivered by scanned focused ultrasound was combined with external beam radiation to treat 15 patients with primary malignant tumors of the brain. A preliminary craniectomy was performed to avoid attenuation of the ultrasound beam by the skull, and multiple thermal sensors were employed to ascertain intratumoral temperatures. The target temperature was 42.5°C at the tumor boundary. This was attained at more than one point during every complete treatment, while a mean temperature in excess of 42°C was achieved within the scanned tumor volume during at least 1 treatment in 11 patients. Technical problems and toxicities are described.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Harris AB, Erickson L, Kendig JH, Mingrino S, Goldring S: Observations in selective brain heating in dogs. J Neurosurg 19:514–521,1962

    Google Scholar 

  2. Lele PP: Thresholds and mechanisms of ultrasonic damage to ‘organized’ animal tissues. In: DeWitt G, Hazzard G, Litz ML (eds) Symposium on Biological Effects and Characteristics of Ultrasound Sources. DHEW Publ. FDA 78-8048, 1977, pp 224–239

  3. Gerweck LE, Richards B: Influence of pH on the thermal sensitivity of cultured human glioblastoma cells. Cancer Res 41:845–849,1981

    Google Scholar 

  4. Overgaard J, Nielsen OS: The role of tissue environmental factors on the kinetics and morphology of tumor cells exposed to hyperthermia. Ann NY Acad Sci 335:254–280, 1980

    Google Scholar 

  5. Gerweck L, Dahlberg W, Epstein L, Shimm D: Influence of nutrient and energy deprivation on cellular response to single and fractionated heat treatments. Rad Research 99: 573–581,1984

    Google Scholar 

  6. Okunieff P, McFarland E, Rummeny E, Willett C, Hitzig B, Neuringer L, Suit H: Effects of oxygen on the metabolism of murine tumors using in vivo phosphorus-31 NMR. Am J Clin Oncol 10:475–482,1987

    Google Scholar 

  7. Sminia P, Haveman J, Ongeboer de Visser BW: What is a safe heat dose which can be applied to normal brain tissue? Int J Hyperthermia 5:115–117,1989

    Google Scholar 

  8. Lindholm CE, Kjellen E, Landberg T, Mercke C, Nilsson P, Persson B: Local ionizing radiation with and without microwave induced hyperthermia in superficial malignant tumors in brain. Adv Exp Med Biol 157:145–146,1982

    Google Scholar 

  9. Dewhirst MW, Moon T, Carlin D: Analysis of tumor volume and thermal dosimetric effects on tumor response to heat, radiation and heat plus radiation: Results of a phase III randomized clinical trial in pet animals. In: Nussbaum GH (ed) Physical Aspects of Hyperthermia. Med Phys Monogr # 8, 1982, pp 495–510

  10. Overgaard J, Overgaard M: Hyperthermia as an adjuvant to radiotherapy in the treatment of malignant melanoma. Int J Hyperthermia 3:483–501,1987

    Google Scholar 

  11. Xu S, Huang Y, Yin S, Hu S, Wang X, Ma F, Tang H: Local hyperthermia combined with radiation in the treatment of advanced cancer. In: Overgaard J (ed) Hyperthermic Oncology 1984, pp 325–328

  12. Westra A, Dewey WC: Variation in sensitivity to heat shock during the cell cycle of Chinese hamster cells in vitro. Int J Radiat Biol 19:467–477,1971

    Google Scholar 

  13. Dritschilo A, Bruckman JE, Cassady JR, Belli JA: Tolerance of brain to multiple courses of radiation therapy. Brit J Radiol 54:782–786,1981

    Google Scholar 

  14. Roberts DW, Coughlin CT, Wong TZ, Fratkin JD, Douple EB, Strohbehn JW: Interstitial hyperthermia and iridium brachytherapy in the treatment of malignant gliomas: A phase I clinical trial. J Neurosurg 64:581–587,1986

    Google Scholar 

  15. Samaras GM, Salcman M, Cheung AY, Abdo HS, Schepp RS: Microwave-induced hyperthermia: an experimental adjunct for brain tumor therapy. Natl Cancer Inst Monogr 61:477–482,1982

    Google Scholar 

  16. Lele PP: Physical aspects and clinical studies with ultrasound hyperthermia. In: Storm FC (ed) Hyperthermia in Cancer Therapy. Hall Medical Publishers, Boston, 1983, pp 333–367

    Google Scholar 

  17. Fry WJ, Mosberg WH Jr, Barnard JW, Fry FJ: Production of destructive lesions in the central nervous system with ultrasound. J Neurosurg 11:471–478,1954

    Google Scholar 

  18. Lele PP: Scanned focused ultrasound for controlled localized heating of deep tumors. In: Anghileri LJ, Robert J (eds) Hyperthermia in Cancer Treatment, Vol 11. CRC Press, Boca Raton, 1986, pp 75–98

    Google Scholar 

  19. Heimburger RF, Fry FS, Franklin TD, Eggleton RC: Ultrasound potentiation of chemotherapy for brain malignancy. Ultrasound Med 1:273–281,1975

    Google Scholar 

  20. Hynynen K, Roemer R, Anhalt D, Xu ZX, Swindell W, Cetas T: A scanned, focussed, multiple transducer ultrasonic system for localized hyperthermia treatments. Int J Hyperthermia 3:21–35,1987

    Google Scholar 

  21. Shimm D, Hynynen K, Anhalt D, Roemer R, Cassady J: Scanned focussed ultrasound hyperthermia: initial clinical results. Int J Radiat Oncol Biol Phys 15:1203–1208,1988

    Google Scholar 

  22. Tobias J, Hynynen K, Roemer R, Guthkelch AN, Fleischer AS, Shively J: An ultrasound window to perform scanned, focussed ultrasound hyperthermia treatments of brain tumors. Med Phys 4:228–234,1987

    Google Scholar 

  23. Oleson JR, Dewhirst MW, Duncan D, Engler M, Thrall D: Temperature gradients: Prognostic and therapeutic implications. New York, IEEE, Proc 7th Ann Conf EMBS, 1985, pp 355–360

    Google Scholar 

  24. Ojemann GA: Surgical treatment of epilepsy. In: Wilkins RH, Rengachary SS (eds) Neurosurgery, Vol 3. McGraw Hill, New York, 1985, pp 2517–2527

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Guthkelch, A.N., Carter, L.P., Cassady, J.R. et al. Treatment of malignant brain tumors with focused ultrasound hyperthermia and radiation: results of a phase I trial. J Neuro-Oncol 10, 271–284 (1991). https://doi.org/10.1007/BF00177540

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00177540

Key words

Navigation