Whole Body Hyperthermia: A Phase-l Trial of a Potential Adjuvant to Chemotherapy
- JOAN M. BULL, M.D.;
- DAVID LEES, M.D.;
- WILLIAM SCHUETTE;
- JACQUELINE WHANG-PENG, M.D.;
- ROSALIE SMITH, R.N.;
- GAITHER BYNUM, M.D.;
- E. RONALD ATKINSON, Ph.D.;
- JOHN S. GOTTDIENER, M.D.;
- HARVEY R. GRALNICK, M.D.;
- THOMAS H. SHAWKER, M.D.; and
- VINCENT T. DeVITA, Jr., M.D.
Abstract
Fourteen patients with a variety of neoplasms not responsive to standard forms of therapy underwent whole body hyperthermia for a maximum 4 h at 41.8 °C. This was a phase-l cancer trial designed to develop whole body hyperthermia as an adjuvant to systemic chemotherapy. Intravenous analgesia was used to sedate patients, obviating the need for general endotracheal anesthesia. Hyperthermia was induced by means of a high-flow water perfusion suit. Cardiovascular performance was evaluated using a flow-directed pulmonary artery catheter. Patients developed a twofold mean increase in cardiac index without evidence of cardiac damage by ECG or creatine Phosphokinase (CPK) isoenzymes. An acute fall in serum magnesium and phosphate and an acute rise in arterial pH, serum CPK values, and granulocyte count occurred in all patients. There were no clotting abnormalities. Toxicity included fatigue, diarrhea, nausea, and transient elevations in liver enzymes. Four patients were febrile for 36 h after initial defervescence. Peripheral neuropathy developed in four. These results show that with carefully monitored conditions whole body hyperthermia is feasible.
Article and Author Information
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▸From the Medicine Branch, Division of Cancer Treatment, National Cancer Institute; the Anesthesiology Department and the Biomedical Engineering and Instrumentation Branch, Clinical Center; the Natick Research Laboratories, National Heart, Lung, and Blood Institute; Bethesda, Maryland.
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▸Requests for reprints should be addressed to Joan M. Bull, M.D.; National Cancer Institute, Building 10, Room 6B16, National Institutes of Health; Bethesda, MD 20014.
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- Received July 17, 1978.
- Accepted October 3, 1978.
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