Lazer Interstitial Thermotherapy In Multimodal Treatment Of Locally Advanced And Recurrent Gynecological Cancer: The Pilot Study

Inspite of achievements in gynecological cancer treatment, more than 50% of treated women had the symptoms of progression in 12-36 mnth. Hyperthermia demonstrates an own antitumor and radiosensitive activity in experiment. The advantages of lazer interstitial thermotherapy (LITT) with interactive dynamic regulation of temperature and depth of heating were evaluated. LITT was used in 30 patients with locally advanced and recurrent gynecological cancer, in 17 pts. (56,6 %) with cervical cancer after neoadjuvant chemo-/radiotherapy, in 4 pts. (13,3%) vaginal cancer, in 5 pts. (16,6%) vaginal or skin metastases of endometrial, ovarian cancer, in 2 (6,6%) recurrent vulvar cancer. All women had the symptoms of progression after previous steps of treatment, with tumor volume 26sm3 – 176sm3. Full course included 3 5 LITT procedures with EBRT or brachytherapy after every LITT procedure. Tumors had been heated by the laser beam up to the temperature 41 43C during 10 min; cylindrical, top end side fibers were used. The response and complications during the treatment were evaluated. CR was determined in 10 pts. (33,3%), PR – in 14 (46,6%), 4 with .75% of regression, with objective acceleration of tumor regression (4,7 vs 1,2 in RT) and therapeutic pathomorphosis III-IV in 67%. LITT was well tolerated, no pain, burning, unexpected toxicity and severe complications were registrated. LITT is a perspective method to improve the results of locally advanced and recurrent gynecological cancer treatment.