DEEP REGIONAL HYPERTHERMIA - COMPARISON BETWEEN THE ANNULAR PHASED-ARRAY AND THE SIGMA-60 APPLICATOR IN THE SAME PATIENTS

Purpose: Several institutions have accumulated clinical experience with the annular array as well as with the Sigma applicator. There exist only limited data in comparison of both heating devices possibly favoring the annular array over the Sigma applicator with regard to tumor temperatures and acute toxicity. The objective of this study was to record temperature distributions at identical sites in tumor and normal tissue in the same patients treated with each device. Methods and Materials: Eighteen patients with advanced pelvic tumors were treated on successive occasions with regional hyperthermia using the annular phased array applicator usually driven at 60-80 MHz or the Sigma applicator usually driven at 70-90 MHz. In all patients detailed thermal mapping and temperature analysis for tumor and normal tissues could be performed. Results: Regardless the device used the acute toxicity was treatment limiting in nearly 50% of the treatments. Systemic stress was treatment limiting in 30% of the treatments with both devices although systemic parameters (core temperature, heart rate, changes in blood pressure) were higher with the annular array. The overall mean minimum, average and maximum tumor temperature observed were 39.5 +/- 1.0-degrees-C, 40.9 +/- 1.4-degrees-C, 42.7 +/- 2.3-degrees-C for the annular array and 39.3 +/- 0.9-degrees-C, 40.9 +/- 1.4-degrees-C, and 42.5 +/- 1.7-degrees-C for the Sigma applicator. The time-averaged temperatures achieved in 20% (T20), 50% (T50) and 90% (T90) of all measured sites were 41.7 +/- 2.1-degrees-C, 40.8 +/- 1.4-degrees-C, 39.9 +/- 1.2-degrees-C for the annular array and 41.7 +/- 1.4-degrees-C, 41.0 +/- 1.3-degrees-C, and 40.1 +/- 1.0-degrees-C, for the S-60. The difference was not statistically significant. With regard to normal tissue temperatures a trend to higher maximum temperatures in the deep muscle and fat tissue was evident for the Sigma applicator. The overall minimum and average normal tissue temperatures in the deep muscle and fat tissue and the rectum and the time-averaged temperatures achieved in 20% (T20), 50% (T50) and 90% (T90) of the measured sites differ not statistically significant. Conclusion: These results indicate that there continue to be unresolved limitations in achieving temperature elevation in deep seated tumors of the pelvis with radiative coherent EM wave techniques using amplitude and phase steering capabilities without any special optimization procedure.