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• W2099764512 abstract "textabstract(English): There is a strong biological rationale for the use of hyperthermia as an oncological treatment modality. Fifteen randomized trials have shown significant improvement in clinical outcome when hyperthermia was added to radiotherapy, chemotherapy or both. At temperatures ≥ 40 0C, heat can cause direct celldeath, especially affecting cells that are relatively resistant to chemotherapy and radiotherapy. In this thesis, the status of hyperthermia in the treatment of locally advanced cervix cancer in the Netherlands is presented and factors predicting outcome are identified. Further, one possible way of improving treatment quality, i.e. by using hyperthermia treatment planning, is explored.The addition of hyperthermia to in this clinical setting results in a significant improvement in local control and a doubling of overall survival, without adding to long-term treatment-related toxicity. Patient-related predictive factors in this clinical setting are tumor stage, tumor size and patient performance status, while the radiation dose as well as thermal dose are predictive treatment-related factors.We found a significant relationship between thermal dose and clinical outcome for 420 patients, indicating that improvement in clinical outcome can be achieved with increased thermal dose. With the help of a hyperthermia treatment planning system, a computer program that optimizes temperature distributions for specific patients, possibly treatment quality can be improved and the thermal dose can be increased. In this thesis, such a computer program is described and adjusted for routine clinical use. Lastly, we conducted a randomized trial to assess its current contribution to treatment quality and thermal dose.(Dutch):Er is een sterke biologische rationale voor het gebruik van hyperthermia in de behandeling van kanker. Vijftien gerandomiseerde onderzoeken hebben aangetoond dat de klinische uitkomst significant verbeterd als hyperthermie wordt toegevoegd aan radiotherapie, chemotherapie of beide. Bij temperaturen ≥ 40 0C, kan warmte direct celdood veroorzaken, met name bij cellen die relatief ongevoelig zijn voor de effecten van radiotherapie en chemotherapie. In dit proefschrift wordt de huidige status van hyperthermie in de behandeling van locaal uitgebreide baarmoederhalskanker onderzocht en worden prognostische factoren geidentificeerd. Als hyperthermie wordt toegevoegd aan radiotherapie in deze setting, resulteert dit in een significante verbetering van de locale controle en verdubbelt de overleving, zonder dat de bijwerkingen van de behandeling op de lange termijn toenemen. Factoren als tumorstadium, tumorgrootte en algemene conditie van de patient beinvloedden de uitkomst, maar ook de radiotherapie- en hyperthermie-dosis zijn significant.We vonden een significante relatie tussen de hyperthermie-dosis en de klinische uitkomst voor een groep van 420 patienten, wat erop duidt dat de klinische uitkomst verbeterd bij hogere hyperthermie-doses. Met behulp van een hyperthermie planningssysteem, een computersysteem waarmee de temperatuurverdeling kan worden geoptimaliseerd, kunnen we mogelijk de kwaliteit van behandeling en ook de hyperthermie-dosis verhogen. In dit proefschrift wordt zo’n computerprogramma beschreven en aangepast voor klinisch gebruik. Ook deden we een gerandomiseerd onderzoek op de bijdrage van het computersysteem aan de kwaliteit en hyperthermie-dosis te onderzoeken." @default.
• W2099764512 created "2016-06-24" @default.
• W2099764512 creator A5050851914 @default.
• W2099764512 date "2010-09-03" @default.
• W2099764512 modified "2023-09-24" @default.
• W2099764512 title "Hyperthermia for the Treatment of Locally Advanced Cervix Cancer" @default.
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