Abstract：
The therapy of high-risk soft tissue sarcomas (STS) remains an interdisciplinary challenge. Regional hyperthermia (RHT) sparked interest as it has been shown to improve overall survival when added to perioperative chemotherapy (CTX). However, questions arise on how RHT should be optimally integrated into current multi-modal therapies.
We performed a systematic literature review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies written in English and focused mainly on radiative RHT and superficial hyperthermia were evaluated and included. Studies including patients below the age of 18, with metastatic disease or review articles, were excluded.
We identified 15 clinical reports from 1990 until July 2022. Three articles combined RHT + CTX, and twelve focused on combined RHT + radiotherapy (RT) or neoadjuvant chemoradiotherapy (CRT). Most treatments were based on invasive thermometry, and less on magnetic resonance imaging (MRI)-based, noninvasive thermometry for STS of the extremities. Perioperative chemotherapy was used for the combination of RHT and CTX, mostly Ifosfamide-based. The effectiveness of RT appeared to be increased by RHT, especially with two RHT sessions/week. The trimodal simultaneous approach of neoadjuvant RHT and CRT was also feasible. No significant toxicity of RHT was reported.
The gathered data strengthen the beneficial role of RHT in the multimodal setting. Further expert consensus and clinical trials are required to determine the optimal integration of RHT in treating STS.
We performed a systematic literature review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies written in English and focused mainly on radiative RHT and superficial hyperthermia were evaluated and included. Studies including patients below the age of 18, with metastatic disease or review articles, were excluded.
We identified 15 clinical reports from 1990 until July 2022. Three articles combined RHT + CTX, and twelve focused on combined RHT + radiotherapy (RT) or neoadjuvant chemoradiotherapy (CRT). Most treatments were based on invasive thermometry, and less on magnetic resonance imaging (MRI)-based, noninvasive thermometry for STS of the extremities. Perioperative chemotherapy was used for the combination of RHT and CTX, mostly Ifosfamide-based. The effectiveness of RT appeared to be increased by RHT, especially with two RHT sessions/week. The trimodal simultaneous approach of neoadjuvant RHT and CRT was also feasible. No significant toxicity of RHT was reported.
The gathered data strengthen the beneficial role of RHT in the multimodal setting. Further expert consensus and clinical trials are required to determine the optimal integration of RHT in treating STS.
摘要：
■高风险软组织肉瘤（STS）的治疗仍然是一个跨学科的挑战。区域性热疗（RHT）引起了人们的兴趣，因为它已被证明可以提高围手术期化疗（CTX）的总生存率。然而,关于如何将RHT最佳地整合到当前的多模式疗法中的问题出现了。
■我们根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行了系统文献综述。评估并纳入了以英语编写的研究，主要集中在放射性RHT和浅表热疗上。研究包括18岁以下患有转移性疾病的患者或评论文章，被排除在外。
■我们从1990年到2022年7月确定了15例临床报告。三篇文章结合了RHT+CTX，12例集中于联合RHT+放疗(RT)或新辅助放化疗(CRT)。大多数治疗都是基于侵入式测温，基于磁共振成像(MRI)的研究较少，四肢STS的无创测温。围手术期化疗用于RHT和CTX联合治疗，主要是基于异环磷酰胺的。RHT似乎增加了RT的有效性，特别是每周两次RHT会议。新辅助RHT和CRT的三模态同时方法也是可行的。没有报道RHT的显著毒性。
■收集的数据加强了RHT在多模态设置中的有益作用。需要进一步的专家共识和临床试验来确定RHT在治疗STS中的最佳整合。
■我们根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行了系统文献综述。评估并纳入了以英语编写的研究，主要集中在放射性RHT和浅表热疗上。研究包括18岁以下患有转移性疾病的患者或评论文章，被排除在外。
■我们从1990年到2022年7月确定了15例临床报告。三篇文章结合了RHT+CTX，12例集中于联合RHT+放疗(RT)或新辅助放化疗(CRT)。大多数治疗都是基于侵入式测温，基于磁共振成像(MRI)的研究较少，四肢STS的无创测温。围手术期化疗用于RHT和CTX联合治疗，主要是基于异环磷酰胺的。RHT似乎增加了RT的有效性，特别是每周两次RHT会议。新辅助RHT和CRT的三模态同时方法也是可行的。没有报道RHT的显著毒性。
■收集的数据加强了RHT在多模态设置中的有益作用。需要进一步的专家共识和临床试验来确定RHT在治疗STS中的最佳整合。
