Purchasing of the ALBA Hyperthermia System for the Radiation Oncology Department of S. Camillo Medical Hospital, Rome

Project location: ITALY, Rome
Project start date: July 2009 - Project end date: This project covers various years
Project number: 2009-12
Beneficiary: ASPRO Onlus


Following up to the purchase of the ALBA Hyperthermia System, between August and December 2010, the Department of Radiation Oncology of the San Camillo-Forlanini Hospital in Rome performed 30 sessions of hyperthermia in combination with radiation therapy.
These treatments were performed on a total of four patients with recurrent skin cancer of the breast. In particular, from a histological point of view, three of them were diagnosed with invasive ductal carcinoma, while the fourth patient had invasive lobular carcinoma.
At the onset of the disease everyone has been subjected to radical surgery (total mastectomy) and postoperative radiotherapy on the chest wall. All patients were also receiving chemotherapy and hormone therapy during their treatment process. The median interval between the initial irradiation of the chest wall and re-irradiation is 9 years.

Radiation treatment in the latter stage was set by using electron energy of 9 MeV with variable collimators, for a total dose between 40 and 50 Gy, administered in 20-25 fractions.
Within an interval of up to 1 hour from irradiation, patients were treated by with the system for superficial/semi-deep hyperthermia Alba Hyperthermia System, operating at a frequency of 434 MHz and equipped with a generator capable of providing a maximum power of 200W. Hyperthermia sessions were performed 1-2 times a week at a distance of 48-72 hours, in order to limit the phenomenon of thermo-tolerance, namely the physiological increase in cellular resistance to heat in the hours immediately following therapy. Irradiation of tissues was prepared by CCMA applicators (Contact Curved Microstrip Applicator). In particular, three patients were treated using the Beta antenna that can cover an area of treatment of 240 cm2, with an EFS (Effective Field Size) of 96 cm2. One patient was treated with the applicator Gamma, with an area equal to 420 cm2 and an EFS of 216 cm2. During treatment, a bolus containing deionized water was placed between the applicator and the patient in order to improve the fit, allowing the maximum power transfer between antenna and tissue, and in order to avoid excessive heating of the skin and subcutaneous fat. A minimum temperature of 41 ° C was set as a target level of the lesion. The total duration of treatment was chosen equal to one hour, including an initial transient interval of 5 to 10 minutes required to reach the hyperthermic temperatures. The average power was set equal to 65W (50-80 W).

For all patients, during treatment, four T-type thermocouple sensors were used for detecting the temperature reached on the surface. The position of the thermocouples was evaluated in order to ensure constant monitoring of the temperature corresponding to the areas to be treated and, simultaneously, the surface areas to be protected from excessive heating. To view and accurately locate the lesion, in order to choose the applicator most suitable to the case to be treated and to ensure optimal placement of temperature sensors, the ultrasound system was used directly connected to the apparatus for hyperthermia Alba, integrated with software for treatment managing. Tolerance to treatment was evaluated according to the CTC v3.0 scale of toxicity.
The analysis showed that three patients reported a G1 acute dermal toxicity, while in one patient there was a dermal toxicity G2. In no patient discontinuation of treatment for toxicity was required and no additional medical treatment was required.

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