Localised deep microwave hyperthermia in the treatment of benign prostatic hyperplasia: long-term assessment.

A group of 133 patients with benign prostatic hyperplasia who were either poor operative risks or who had refused surgery underwent localised deep microwave hyperthermia, without supplementary drugs. In 59% of patients who had had an indwelling catheter, freedom from urological obstruction and satisfactory voiding were maintained for 7 years and catheterisation was not required. In patients with severe prostatic symptoms, 65% showed general improvement and satisfactory voiding for 8 years. There were no side effects. Patients who relapsed were given a second course of treatment and 75% responded positively. This positive response and the lack of side effects suggest that localised deep microwave hyperthermia may be an effective alternative to surgery in the management of high risk patients and those who are reluctant to undergo surgery.

[Noninvasive, local microwave hyperthermia for deep-seated tumors: III. Benign prostatic hyperplasia].

Poor operative risk patients with benign prostatic hyperplasia were treated as outpatients with local hyperthermia without sedation, for 1 hour, twice weekly. As a result of the treatment it was possible in 61% to remove indwelling catheters and voiding was resumed for up to 61 months after treatment. 70% of those without indwelling catheters improved clinically and remained so for 67 months after completion of treatment. There were no side-effects or sequellae of the treatment. Because of its safety, simplicity of application and good results, it is recommended as the treatment of choice for poor operative risks.

[Local hyperthermia of upper respiratory passages for perennial allergic rhinitis].

Local hyperthermia (43 degrees C) to the upper respiratory passages, without supplementary drugs, relieves symptoms of perennial allergic rhinitis. Treatment consisted of 3, 30 minute sessions at 1-hour intervals during a single day. 69% were free of their symptoms during the month following treatment, and 52, 37 and 28% were free for 4, 8 and 12 months, respectively. The accumulated clinical experience with 95 patients aged 5-72 years demonstrates that local hyperthermia of the upper respiratory tract is effective in the treatment of perennial allergic rhinitis, with no immediate or long term side-effects.

Efficacy of sustained-release radioprotective drugs in vivo.

In previous publications from this laboratory we suggested the use of radioprotective drugs in a sustained-release form as a practical way to cope with their high toxicity and quick metabolism and excretion. Cysteine and cysteamine, well-established radioprotectants, were used as model drugs and compressed at various concentrations (0-65%) into an insoluble tablet matrix, composed of ethylcellulose and stearic acid at various ratios and compression pressures. We demonstrated in vitro that when the release rate of the radioprotectants was measured under nitrogen, the kinetic data conformed with the Higuchi square root of time equation, indicating that the release of both drugs correlates with Higuchi's diffusional mechanism. In the present in vivo study, tablets containing cysteine or cysteamine in a slow-release matrix were implanted, into the stomachs of female rats. The rats were irradiated at various time intervals up to 12 h after implantation and their survival recorded daily. Utilizing a 1:3 ratio of ethylcellulose:stearic acid as a matrix, the protective effect of the drugs was remarkable eight hours after tablet implantation. The results reported indicate that slow-release tablet formulation is a possible method for delivering of radioprotective drugs over an extended period of time.

Local microwave hyperthermia in the treatment of carcinoma of the prostate.

The clinical electromagnetic hyperthermia system has been in use at the Kaplan Hospital since 1980, for treating patients with hyperthermia combined with radio- or chemotherapy. For prostatic tumors, hyperthermia at 43 degrees C is achieved in the prostatic mass using microwaves of 2.45 GHz, with simultaneous cooling of the rectal mucosa and the rectal wall. Thirty-two patients with carcinoma of the prostate have been treated: 4 with heat alone, 20 with hyperthermia combined with radiotherapy, and 8 with hyperthermia combined with hormonal therapy. Follow-up was carried out up to 34 months. Objective local tumor regression was achieved in 3 out of 4 patients treated by heat alone, but the patients relapsed after 6 months. All the 20 patients treated with combined hyperthermia and radiotherapy responded to treatment. Patients treated with combined hyperthermia and hormone therapy responded locally to treatment but died of their metastatic disease, or of unrelated diseases with a follow-up period up to 31 months. Hyperthermia did not increase morbidity beyond that expected for radiation therapy.

Localized deep microwave hyperthermia in the treatment of poor operative risk patients with benign prostatic hyperplasia.

Non-invasive localized deep microwave hyperthermia was applied as an alternative treatment to surgery in 29 patients with contraindications for prostatectomy. Patients were treated twice weekly, on Mondays and Thursdays, for 1 hour, without sedation on an outpatient basis. All patients tolerated treatment well without secondary effects. The results indicate that localized deep microwave hyperthermia applied by this method is safe and effective in the treatment of benign prostatic hyperplasia.

Percutaneous venography and occlusion in the management of spermatic varicoceles.

Spermatic venography was performed in 140 patients; the main indications were subfertility and abnormal spermatogenesis. Of these 140 patients, 113 had positive examinations, with 33 of them having bilateral varicoceles. Of 146 total varicoceles demonstrated, 42 were found on the right side; the advantage of using the jugular vein approach in both the diagnosis and percutaneous treatment of these cases is stressed. Of the 146 varicoceles, 128 were successfully occluded using spring coils. Because of the frequency of bilateral subclinical varicoceles, spermatic venography and percutaneous embolization is recommended in all men with subfertility and oligoteratoasthenospermia.

Systemic alteration in blood glucose levels following localized deep microwave hyperthermia.

Blood glucose levels were temporarily elevated in normal rabbits subjected to one localized microwave hyperthermia treatment in the rectum. A major peak of blood glucose level was observed 8 hours after treatment, and a second minor peak was measured 14-17 hours after treatment. These findings indicate that localized microwave hyperthermia affects the host systemically.

Sensitization of combined cis-platinum and cyclophosphamide by local hyperthermia in mice bearing the Lewis lung carcinoma.

The combined effect of cis-platinum cyclophosphamide, and local hyperthermia was investigated in mice bearing the metastatic Lewis lung carcinoma. The combined action of cyclophosphamide and cis-platinum resulted in an additive effect. The triple combination of cis-platinum, cyclophosphamide and local hyperthermia revealed thermal potentiation of the combined drug-induced growth delay.

Inhibition of non-neuronal cell proliferation in the goldfish visual pathway affects the regenerative capacity of the retina.

Proliferating cells associated with the visual pathway were found in the present study to affect the regenerative capacity of the goldfish retina following optic nerve injury. The contribution of these cells to the process of regeneration was investigated in the goldfish visual system by reducing their proliferation in the optic tract and tecta, using X-irradiation. The regenerative ability of the retina was then evaluated by the following parameters: sprouting from retinal explants, protein synthesis in the retina and accumulation of radiolabeled transported components in the tectum. X-irradiation of the visual system at an early stage of the regeneration process had a promoting effect whereas irradiation at a later stage resulted in a reduced capacity to regenerate. The results are discussed with respect to the possibility that proliferating cells, possibly glia, exert two contradictory contributions: an inhibitory effect at the site of injury, whereas distal to it, a supportive, perhaps trophic effect.

Normal tissue response to localized deep microwave hyperthermia in the rabbit's prostate: a preclinical study.

Experiments were performed to determine the response of normal tissues of the rectal cavity and the prostate to localized 2.45 GHz microwave deep hyperthermia. Hyperthermia at 43 degrees C was delivered by means of a coaxial probe in the rectal cavity for 30 min. once or twice at an interval of 2 days. Normal tissues of the rectum, urinary bladder, and prostate were histologically examined up to three months after treatments. In almost all of the treated animals no tissue and organ injury resulted from localized deep hyperthermia at 43 degrees C. This treatment appears to be safe for the treatment of carcinoma of the prostate.

Treatment of perennial allergic rhinitis by local hyperthermia.

Ninety-five patients with documented perennial allergic rhinitis have been treated with local hyperthermia of the nasal passages in a randomized double-blind trial. The treatment consisted of one series of three 30-min insufflations of humidified air at 43 degrees C at a 2-hr interval. In the active treatment group, 75% (P less than 0.00003) and 68% (P less than 0.00001) of the patients were free of symptoms 1 week and 1 month, respectively, after treatment, compared with a 28% and 17% response in the placebo group. We conclude that local hyperthermia is effective in the treatment of perennial allergic rhinitis.

Local hyperthermia for treatment of carcinoma of the prostate: a preliminary report.

Following extensive experiments on animals, we have concluded a study on the treatment of 15 patients with prostatic carcinoma using localized deep microwave hyperthermia (LDMWH; 2.45 GHZ), either alone or in combination with radiotherapy or hormonal therapy. The results of this pilot trial were encouraging and are herewith presented. A total of 146 LDMWH treatments were given. All patients tolerated the treatments well, and there were no complications; the condition of the rectal mucosa was checked routinely by rectoscopy. A pronounced and rapid subjective and objective response was recorded in all cases, as noted by reduction in tumor size, regression of ureteral or urethral obstruction, disappearance of pelvic pain and improvement in well being. LDMWH was effective by itself and appeared to potentiate the effects of radiotherapy or hormonal therapy. Although LDMWH seems to be a promising and safe new method of treatment of prostatic cancer, either alone or in combination with other accepted forms of therapy, more controlled studies, which are at present underway, are needed to draw more definite conclusions.