Informationen für Ärzte

SASCRO Conference, Cape Town / SASCRO Konferenz, Kapstadt

We are very happy that Dr. Carrie Minnaar Strauss represented Oncotherm at an lmportant South African Conference. She presented a scientific Oncotherm poster at the SASMO (South African Society of Medical Oncology) and SASCRO (South African Society of Clinical Radiation Oncology) Congress that was held from August 7th to 9th, 2015 in Cape Town, South Africa, titled: "Oncothermia - a complex treatment approach". The poster was done together wlth PD Dr. Oliver Szasz. Dr. Minnaar Strauss also represented Oncotherm as exhibitor at a booth and meet many interested doctors.

Wir freuen uns, dass uns Dr. Carrie Minnaar Strauss Oncotherm auf einer wichtigen südafrikanischen Konferenz repräsentiert hat. Sie stellte ein wissenschaftliches Oncotherm Poster auf dem SASMO (South African Society of Medical Oncology) und SASCRO (South African Society of Clinical Radiation Oncology) Kongress vor, der vom 7. - 9. August 2015 in Kapstadt, Südafrika stattfand. Der Titel lautete "Oncothermia - a complex treatment approach". Das Poster wurde gemeinsam mit PD Dr. Oliver Szasz entwickelt. Dr. Minnaar Strauss hat Oncotherm ebenfalls als Aussteller an einem Stand
vertreten und die Fragen vieler interessierter Ärzte beantwortet.

Oncothermia has more than 20 years clinical experience. It has wide range of applications in 30 countries all over the world, distributing their intra-Iuminar, loco-regional and multi-Iocal systems. Despite the market successes the skepticism is vivid just as the complete oncological hyperthermia topic has been for centuries. Oncothermia is a capacitive coupling technology. This technical solution is well-known for almost a century introduced by Siemens in the early thirties of the 20th century. Multiple devices were developed from that time on in Germany, France, the USA, Japan, Italy, etc. but the desired clinical breakthrough was not achieved. A new concept of capacitive coupling was developed by Oncotherm 25
years aga making impedance matching and applying some modern technical and biomedical results, adding permanently the state-of-art knowledge from the latest outcomes of medical researches [1].

The popularity of the device worldwide and the massive number of the highly professional users who work on more than one oncothermia devices produce huge amount of clinical results every day [2], [3], [4], [5]. The published studies show excellent results on advanced cases of lung (NSCL) (more than 400 patients) ; [6], [7], [8], (SCLC) (n=31), [9]) brain gliomas (n=15) [10], (n=140) [11], (n=36) [12], (n=19) [13], advanced sarcomas (n=13) [14], (n=24) [15], advanced liver (n=80) [16], (n=21) [17], (n=60) [18], (n=22) [19], advanced inoperable pancreas tumors [2], (n=26) [21], monotherapy applications when all other possibilities fail, (n= 16) [22], bone-metastasis (case report) [23], prostate tumor [24], [25].

The recently ongoing clinical studies on advanced oncological situations are very promising:
• advanced, relapsed ovarian cancer, (Korean National Cancer Institute, Seoul, Korea)
• advanced cervix tumor (Chonbuk National University Hospital, Korea)
• pharmacokinetic studies (Chonbuk National University Hospital, Korea)
• advanced, relapsed, HIV connected cervical cancer (University of Witwatersrand, Johannesburg,S.    Africa)
• advanced, relapsed esophagus cancer (Chiba University, Chiba, Japan)
• advanced, metastatic breast cancer (Thai National Cancer Institute, Bangkok, Thailand)
• advanced, pancreatic cancer with liver metastases (Thai National Cancer Institute, Bangkok, Thailand)
• advanced breast and gynecology cancer (University of Toyama, Toyama, Japan)
• phase I/II trial breast cancer (Ludwig-Maximillians University, Munich, Germany)
• traditional Chinese medicine and Oncothermia (Clifford Hospital, Guangzhou, China)
• pancreas cancer (Seoul National University Bundang, Seoul, Republic of Korea)
• adenocarcinoma of the lung (Bundang Cha General Hospital, Seoul, Republic of Korea)
• ovarian cancer (National Cancer Institute, Seoul, Republic of Korea)
• epithelial ovarian cancer (Seoul National University Bundang Hospital, Bundang, South Korea)
• sarcoma (Kosin University, Busan, Republic of Korea)
• advanced ovary cancer (Ewha Womans University Cancer Center for woman, Seoul, Republic of Korea)
• inoperable pancreatic cancer (Seoul National University Bundang Hospital, Bundang, South Korea)
• lung adenocarcinoma (Bundang Cha General Hospital, Seoul, Republic of Korea)
Based on these strong data set from clinical studies oncothermia is eligible to be a solid part of the everyday oncologic treatment in many indications. In order to obtain the overall worldwide clinical acceptance further actions are required such as the collection of the prospective and retrospective data from the certified Crnica, studies.

References
[1] Szasz A, Szasz N, Szasz 0 (2010) Oncothermia - Principles and practices. Springer Science, Heidelberg, http://www.springer.com/biomed/cancer/book/978-90-481-9497 -1
[2] Kaltsas H. Too hot for cancer: hyperthermia and electrotherapy. Altern MEjd.2007;37: 1-8,
http://www.biomatnetwork.com/defau It/down loads/Too%20Hot ... pdfl
[3] Douwes FR, (2007) Hyperthermie in der Tumortherapie, in ErfahrUngsheiltunde 56:206-211, https://www.thiemeconnect.de/DOI/DOI? 10.1055/s- 2007 -968081
[4] Gould D. (2001) Hyperthermia and Electrochemical Therapy at St. Georg Hospltat, Germany, Alternative and Complementary Therapies. October 2001, 7(5): 291-295. doi: 10.1089/107628001753312130, http://online.liebertpub.com/doi/abs/10.1089/10762800 1753312130
[5] Douwes FR, (2001) Hyperthermia a new treatment modality in cancer; Focus on Alternative and Complementary Therapies, 6:77-77, http://onlinelibrary. wiley.com/doi/10.1111/j.2042-7166. 2001.tb02808.x/abstract. ..
[6] Szasz A (2014) Current status of oncothermia therapy for lung cancer. Korean J Thorac Cardiovasc Surg 47:77-93, http://www.ncbi.nIm.nih.gov/pmc/articles/PMC4000888
[7] Lee DY, Park JS, Jung HC, et.al. (2015) The outcome of the chemotherapy and oncothermia for far advanced adenocarcinoma of the lung: case reports of four patients, Advances in Lung Cancer, 4, 1-7,
http://www.scirp.org/Journal/PaperInformation.aspx?PaperID=54620
[8] Seung-Gu Yeo (2015) Definitive radiotherapy with concurrent oncothermia for stage IIIB non-small-cell lung cancer: A case report. Journal of Advances in Physics 10(1):2538-2559, http://tessera.spandidos-publications.com/10.3892/etm. 2015.2567
[9] Doo Yun Lee, Seok Jin Haam, Tae Hoon Kim, Jae Yoon Um, Eun Jung Kim, Na Young Kim (2013) Oncothermia with chemotherapy in the patients with Small Cell Lung Cancer. Hindawi Publishing Corporation Conference Papers in Medicine,Volume 2013, Article ID 910363, http://www.hindawi.com/iournals/cpis/2013/910363/
[10] Wismeth C, Dudel C, Pascher C, Ramm P, Pietsch T, Hirschmann B, Reinert C, Proescholdt M, Rümmele P, Schuierer G, Bogdahn U, Hau P (2010) Transcranial electro-hyperthermia combined with alkylating chemotherapy in patients with relapsed high-grade gliomas - Phase I clinical results. J Neurooncol 98(3): 395-405, http://www.ncbi.nlm.nih.gov/pubmed/?term=Transcranial+electrohyperthermia+combined +with+ alkylating+chemotherapy ...
[11] Sahinbas H, Groenemeyer DHW, Boecher E, Szasz A (2007) Retrospective clinical study of adjuvant electrohyperthermia treatment for advanced brain-gliomas. Deutsche Zeitschrift fuer Onkologie 39: 154-160,
http://www.researchgate.net/publication/240951416 Retrospective clinical study of ...
[12] Hager ED, Dziambor H, App EM, Popa C, Popa 0, Hertlein M (2003) The treatment of patients with high-grade malignant gliomas with RF-hyperthermia. Proc ASCO 22: 118, #47;Proc Am Soc Clin Oncol 22: 2003,
http://www.oncotherm.com/web/cus/%2866%29%20Hager%20ASCO.PDF
[13] Douwes F, Douwes 0, Migeod F, Grote C, Bogovic J (2006) Hyperthermia in combination with ACNU chemotherapy in the treatment of recurrent glioblastoma. St. Georg Klinik, Germany, http://www.klinik-st-georg.de/fileadmin/publikationen/en/hyperthermia... pdf
[14] Jeung TS, Ma SY, Choi JH, Yu J, Lee SY, Um S (2015) Results of oncothermia combined with operation, chemotherapy and radiation therapy for primary, recurrent and metastatic sarcoma, Case Rep Clin Med, 4, 157-168, http://www.scirp.org/journal/PaperInformation.aspx?PaperID- 56280
[15] Volovat C, Volovat SR, Scripcaru V, Miron L, Lupascu C (2014) The results of combination of ifosfamid and locoregional hyperthermia (EHY 2000) in patients with advanced abdominal soft-tissue sarcoma after relapse of first line chemotherapy. Romanian Reports in Physics, Vol. 66, No. 1, p. 175-181, http://www.rrp.infim.ro/2014 66 1/A19.pdf
[16] Hager ED, Dziambor H, Höhmann D, Gallenbeck D, Stephan M, Popa C (1999) Deep hyperthermia with radiofrequencies in patients with liver metastases from colorectal cancer. Anticancer Res 19(4C):3403-3408, http://www.ncbi.nlm.nih.gov/pubmed/10629627
[17] Gadaleta-Caldarola G, Infusino S, Galise I, Ranieri G, et.al. (2014) Sorafenib and locoregional deep electrohyperthermia in advanced hepatocellular carcinoma: A phase Ir study, Oncology Letters, 8: 1783-1787, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4156230/
[18] Fiorentini G, Milandri C, Dentico P, Giordani P, Catalano V, Bunkeila F (2012) Deep electro-hyperthermia with radiofrequencies combined with thermoactive drugs in patients with liver metastases form colorectal cancer (CRC) a phase Ir clinical study. 31st Conference of International Clinical Hyperthermia Society (ICHS), Budapest, Hungary, October 12-15, 2012
[19] Ferrari VD, De Ponti S, Valcamonico F, et.al. (2007) Deep electro-hyperthermia (EHY) with or without thermo-active agents in patients with advanced hepatic cell carcinoma: phase Ir study, J Clin Oncol 25: 18S; 15168, http://meeting.ascopubs.org/cgi/content/short/25/18 suppl/15168
[20] Hager ED, Süsse B, Popa C, Schritttwieser G, Heise A, Kleef R (1994) Complex therapy of the not in sano respectable carcinoma of the pancreas - a pilot study. J Cancer Res Clin Oncol 120:R47,P1
[21] Volovat C, Volovat SR, Scripcaru V, Miron L (2014) Second-line chemotherapy with gemcitabine and oxaliplatin in combination with loco-regional hyperthermia (EHY-2000) in patients with refractory metastatic pancreatic cancer - preliminary results of a prospective trial. Romanian Reports in Physics 66(1): 166-174, http://www.rrp.infim.ro/2014 66 1/A18.pdf
[22] Jeung T S, Ma S Y, Um S, Sangwook L (2013) Cases That Respond to Oncothermia Monotherapy. Hindawi Publishing Corporation Conference Papers in Medicine, Volume 2013, Article ID 392480,
http://www.hindawi.com/journals/cpis/2013/392480/
[23] Rubovszky G, Nagy T, Godeny M, Szasz A, Lang I (2013) Successful treatment of solitary bone metastasis of nonsmall cell lung cancer with combination of bevacizumab and hyperthermia. Pathol Oncol Res. 2013 Jan; 19(1): 119-22, http://link.springer.com/article/10.1007%2Fs12253-012-9551-7
[24] Douwes FR, Ueberman S. (2002) Radiofrequency Transurethral Hyperthermia and Complete Androgen Blockade: A Nonsurgical Approach to Treating Prostate Cancer. Alternative & Complementary Therapies. 2002;8(3): 149-156, http://www.klinik-st-georg.de/fileadmin/publikationen/en/radiofreguency ... pdf
[25] Douwes FR, (2001) Transurethral hyperthermia in early stage prostate cancer, Focus on Alternative and Complementary Therapies 6: 77-78; http://onlinelibrary.wiley.com/doi/10.1111/j.2042-7166.200 1.tb02809.x/full

Quelle: Oncotherm Newsletter 2015/ 09

Scientific Topic: Comparison Oncothermia/ Hyperthermia

A complete technical comparison of oncothermia systems with other capacitive hyperthermia systems in the same frequency range is collected in the table below.

#	Parameters			Traditional Capacitive Hyperthermia (8MHz～13.56MHz)	Oncothermia（13.56MHz, modulated）
1	Goal of heating			necrosis of tumor	apoptosis of malignant cell
2	Heating	methods		macro-heating (selected by macroscopic impedance differences)	micro-heating (nano-selected by microscopic impedance differences)
		object		entire tumor volume	cell membrane of malignant cells
		output power		over 1W/cm2, (generally >500W)	less than 0.5W/cm2, (generally <250W)
3	Focusing	patient movement		smeared by patient movements	current follows movement of patient
		time effect		heat-spreads over time	low heat-spreading due to micro-mass-effect
4	Electrode system	symmetry		geometric and electric symmetry	geometric and elctric asymmetry
		electric parameter		voltage dominating	current centered
		coupling		plane-wave coupling	impedance coupling
5	Penetration depth (determined by electrode setting)			shorter determined by the plane waves	longer determined by the RF-current-density
6	Selectivity	by object	conductivity of malignant tissue	theoretically works, but RF voltage centered coupling of the electrodes and the macro-heating cancel the effect (overheating cancels the selectivity and the effect)	effectively works by micro-heating with strong impedance coupling
			permittivity of cells
		by RF characteristics	β-dispersion on membrane
		by pathologic pattern	fractal modulation	not built-in	built-in
7	Physiologic effect	effect on blood flow		first vasodilation, then vasocontraction over a threshold temperature, uncontrollable	mild overall heating, only slight vasodilatation, controllable below the vasocontraction threshold
		effect of homeostatic feedbacks		strong feedback of reestablishing homeostatic equilibrium, which works against the heating	weak homeostatic counter-actions, therefore hyperthermia acts effectively
		immune activation		immune-cells are active only below 40°C, therefore unworkable	working due to mild heat-effect
		surface cooling		strong cooling with extra bolus solution	homeostatic cooling, no extra (secondary) bolus cooling, keeping the homeostatic equilibrium
8	Heating result on cell-death			dominantly necrosis, minor apoptosis by internal apoptotic pathways (in mitochondria)	dominantly apoptosis  happens via external pathways (surface of cell membrane)
9	Dose facility			temperature (°C）[CEM43CTx (min)]	energy like in case of the ionizing radiation  (Gy=J/Kg)
10	Safety and side effect	risk of invasion		broken adherent connections and collapsed cytoskeleton facilitate the invasion of malignant cells	reestablished adherent connections and rebuilt cytoskeleton of malignant cells blocks the invasion of malignant cells
		risk of metastases		high vasodilatation might induce dissemination of malignant cell	low vasodialtion doesn't force dissemination of malignant cells
		risk of burning		high-risk of  burning toxicity	low-risk of burning toxicity
11	Complementary applications	chemotherapy		the forced over-threshold temperature (>40°C) makes vasocontraction, limits the anyway hard drug delivery to the tumor	good synergy with the drug-deliveries extending the chemotaxis with electrotaxis
		radiotherapy		the forced over-threshold temperature (>40°C) creates hypoxia and decreases the efficacy of radiotherapies	no hypoxia is presented, the radio-sensitization is increased
12	Immune activity	immune effects		uncontrolled, necrosis reference (CEM43°CTx) [calibrated in-vitro]	massive production of apoptotic bodies and damage associated molecular pattern (DAMP): mHSP70 + HMGB1 + Calreticulin
		bystander and abscopal effect		rare abscopal phenomena	frequent abscopal phenomena, immunogeric cell-death (ICD)

Quelle: Oncotherm Newsletter 2015/ 05