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The History of Hyperthermia Rise and Decline

机译：热疗史的兴衰

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Electromagnetic hyperthermia remains experimental treatment after 40 years of research and application in view of its “temperature concept” based on the belief that temperature is the only parameter of the efficacy. Initial “extreme hyperthermia” concept was based on the wrong premise of much higher thermal susceptibility of malignant cells and broad therapeutic range of hyperthermia, allowing to kill tumor cells by above-threshold (>43°C) temperature without damaging healthy tissues. Indeed, this therapeutic gap is minor or absent which makes the extreme hyperthermia impossible. The next concept of “thermal dose” was based on the ungrounded extrapolation of the biochemical Arrhenius relationship onto the living matter and formed the basis of “moderate hyperthermia” concept, believing that it could enhance tumor oxygenation and radio- and chemosensitivity, ignoring the special features of tumor blood flow. Both concepts have not been confirmed; “thermal dose” is currently proven to be not connected with any clinical outcome. Analysis of randomized trials with respect to biases has not confirmed hyperthermia efficacy. The growing evidence of athermal effects and their broad application has caused development of some athermal cancer treatments. Hyperthermia concept should be cardinally reevaluated now with respect to obvious bankruptcy of the temperature concept and development of the athermal concept.
机译：基于“温度概念”的认识，电磁高温疗法经过40年的研究和应用，仍然是实验性治疗手段，而人们认为温度是功效的唯一参数。最初的“极端体温过高”概念是基于错误的前提，即错误的前提是恶性细胞的热敏感性高得多，并且热疗的治疗范围广，可以在高于阈值（> 43°C）的温度下杀死肿瘤细胞而不会损害健康组织。实际上，这种治疗间隙很小或没有，这使得不可能进行极端的体温过高。下一个“热剂量”概念是基于对生化物质阿奇瑞尼斯（Arrhenius）生化关系的无根据推断，并形成了“中度热疗”概念的基础，认为它可以增强肿瘤的氧合作用以及放射和化学敏感性，而忽略了特殊之处。肿瘤血流的特征。这两个概念尚未得到证实。目前证明“热剂量”与任何临床结果均无关。关于偏倚的随机试验分析尚未确认热疗功效。越来越多的无热效应证据及其广泛应用已导致一些无热癌治疗方法的发展。现在，就温度概念的明显破产和无热概念的发展而言，应该重新对高温概念进行重新评估。

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