Hyperthermia combined with radiotherapy: Prognostic significance

BACKGROUND Loco-regional failure following radiotherapy for locally-advanced cervical tumours is an important problem. The effect of adding hyperthermia to standard radiotherapy was prospectively investigated in a randomised trial. METHODS From 1990 to 1996, 114 patients were entered into the trial. Standard radiotherapy was applied to a median total dose of 68 Gy. Hyperthermia was given once weekly. The statistical analysis was performed according to the intention to treat principle. The primary objectives of the trial were complete response and duration of local control, secondary objectives were overall survival and toxicity. RESULTS Complete response rates were 57% following radiotherapy and 83% following radiotherapy + hyperthermia (p = 0.003) The difference in local control was maintained during follow-up. Three-year overall survival rates were 27 and 51% following radiotherapy and radiotherapy + hyperthermia, respectively (p = 0.009). Multiple logistic regression analysis showed for both local control and overall survival that addition of hyperthermia was an independent factor improving the outcome. Radiation toxicity was not enhanced by hyperthermia. CONCLUSION Hyperthermia in addition to standard radiotherapy of locally-advanced cervical tumours results in therapeutic gain.