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Title: The effects of induced hyperthermia in advanced malignant disease
Author: Ludgate, C. M.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1977
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Fever therapy in the treatment of cancer is reviewed. Biochemical mechanisms of heat induced cellular damage are discussed with ways of potentiating the selective lethal effect. Conditions inducing heat resistance are stated. Relationship of temperature to time above the 'critical temperature' for cell death is described. A clinical unit of heat stress, the centigrade degree minute is defined and used in subsequent studies. Animal work involving treatment by temperatures in excess of 400 °C. (hyperthermia) is reviewed. Methods of inducing whole body hyperthermia are described, and the difficulties discussed. Dr. Pettigrew's method is described. Physiological studies during hyperthermic therapy of disseminated human cancer investigating the haemodynamic response, fluid and electrolyte losses, and modifications of replacements required to produce a stable, safe treatment are described. Liver sensitivity limited the maximum therapeutic temperature. Increasing stress and a leucocytosis was observed during treatment. Prolonged treatment in sensitive tumours induced disseminated intravascular coagulation necessitating fractionation of therapy. Tumour response to treatment is assessed and complications noted. Whole body hyperthermia alone was not curative but caused good short term palliation of sensitive tumours. A new method involving hyperthermic perfusion of the distended urinary bladder for transitional cell carcinoma is described. Advantages including tumour exposure, heat gradient and reproduceable effects are discussed. Following perfusion under epidural anaesthesia the damage to tumour and normal bladder was proportional to the treatment given; that necessary for deep tumour necrosis produced unacceptable damage to the normal bladder. Therapy was limited by vascular thrombosis in the bladder wall. Treatment given by smaller daily fractions did not summate. Treatment without epidural anaesthesia was ineffective and the reasons for this are discussed. Vascular damage was of use in arresting gross haematuria. Hyperthermia alone was palliative but combination with radiotherapy or chemotherapy may be curative.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available