Systemic thermotherapy: description of a method and physiologic tolerance in clinical subjects.

A safe, effective method of inducing total body hyperthermia to 42 degrees C (108 degrees F) has been developed and applied to clinical subjects with advanced malignancy. Physiological and biochemical parameters have been studied to determine tolerance and detect toxicity. Treatments were well tolerated with appropriate life support measures, mainly fluid and electrolyte replacement. Occasional arrhythmias and superficial cutaneous burns were the major complications. No evidence of central nervous system dysfunction was detected. Serum enzyme elevations after treatment appeared to indicate hepatic cellular injury but no clinical problems resulted. Renal, pulmonary, and hematologic parameters showed no significant changes from baseline values. Two early deaths occurred in patients with massive liver replacement with tumor and such patients may not be appropriate subjects for hyperthermia.

Immunologic function in humans before and after hyperthermia and chemotherapy for disseminated malignancy.

Multiple immunologic parameters were studied in three patients prior to and after hyperthermia treatment for disseminated malignancy. Two patients had malignant melanoma and received chemotherapy during the hyperthermia treatment. One had adenocarcinoma of the stomach and received no concomitant chemotherapy. Rapid rosettes as a measure of thymus-derived lymphocytes (T-lymphocytes) were found to increase significantly after therapy (P less than 0.05) both in percentage and absolute numbers. There was no change in the numbers or percentages of other markers for T-lymphocytes or bone marrow-derived B-lymphocytes. Complement profiles revealed a significant decrease in C3 (P less than 0.005) after hyperthermia but no change in levels of other components of the alternate pathway. Antibody-dependent lymphocyte-mediated cytotoxicity and polymorphonuclear cell-mediated antibody-dependent cytotoxicity were also depressed after hyperthermia. No change was observed in immunoglobulin levels with hyperthermia therapy. Results indicated that hyperthermia may favorably alter the immune balance between tumor and host in selected instances.