Oncology

Magna Clinic is at the Oncology field a reference center, specially in Oncological Hyperthermia treatment. Several specialities and treatments will help our patients and their relatives in the diagnosis and treatment of the disease.

Customized treatment

Our patient’s care and comford it’s the most important thing to us, therefore our team will give you an exclusive and continued treatment. Our patient’s care from the diagnosis and the therapy to the further follow-up, is our main aim. Our nursing department has a large experience, offering our patients full care.

Our medical team evaluates each case, cooperating amongst themselves, different specialities to make a complete evaluation of the patient and find out which treatment is the best for this case. Informative appointments are offered to resolve any doubt our patients might have.

What to treat:

Superficial Tumors:

  • Melanomas
  • Epithelioma
  • Cutaneos Metastases
  • Lymph nodes
  • Superficial relapse


Deep tumors:

  • Colon
  • Kidneys
  • Esophagus
  • Stomach
  • Bladder
  • Brain
  • Tongue-Pharynx
  • Head and Neck
  • Larynx
  • Prostate
  • Breast
  • Maxilofacial
  • Jaw
  • Cheek
  • Male sexual organs
  • Retum
  • Female sexual organs
  • Sarcomas
  • Lung
  • Pleura
  • Pancreas
  • Pelvis
  • Liver
  • Bones

Important results:

Soft Tissue Sarcoma

A german phase III trial was presented by Issels and others in the annual meeting ASCO of 2007, it includes 342 patients with a high risk Sarcoma, with neo adjuvant Chemotherapy plus Radiotherapy treatment with or without Hyperthermia: 37% of the patients with Hyperthermia treatment got a 50% reduction of the volume of the tumor compared to the 12% of the arm without hyperthermia. The average survival rate with or without Hyperthermia was 30 and 16 months, respectively. The trial confirmed the Prosnitz and others previous american trial in phase III, where they obtained a local control of 95% with neo adjuvant Radiotherapy plus local Hyperthermia in 97 patients affected with high risk Sarcomas in limbs.

% of tumor reduction
  • 12% Only Chemo and Radio
  • 50% Chemo+Radio+Hyperthermia

(Issels RD, Lindner LH, Wust P, Hohenberger P, Jauch K, Daugaard S, Mansmann U, Hiddemann W, Lay J, Verwei J: Regional hyperthermia improves response and survival when combined with systemic chemotherapy in the management of locally advanced, high grade soft tissue sarcomas of the extremities, the body wall and the abdomen: A phase III randomised prospective study. J Clin Oncol, 25: 18S (June 20 Suppl): 10009, 2007.)

(Prosnitz LR, Maguire P, Anderson JM, Scully SP, Harrelson JM, Jones EL, Dewhirst M, Samulski TV, Powers BE, Rosner GL, Dodge RK, Layfield L, Clough R, Brizel DM: The treatment of high-grade soft tissue sarcomas with preoperative thermoradiotherapy. Int J Radiat Oncol Biol Phys, 45: 941-949, 1999.)


Pelvic advanced tumors

A dutch multicenter trial, made by van der Zee and others, with 358 patients, found full recovery rates that went from 51% to 73% in bladder tumors and from 57% to 83% in uterine cervix cancer compared with only Radiotherpy.

% of full recovery in bladder cancer
  • 51% Only Radiotherapy
  • 73% Radiotherpy+Hyperthermia
% of full recovery in cervix cancer
  • 57% Only Radiotherapy
  • 83% Radiotherapy+Hyperthermia

In summary, survival increased from 27% to 51%.
Therefore a Russian trial of advanced rectal cancer, in 1993, Berdov and Menteshashvili provided regional Hyperthermia to Radiotherapy, and informed a 5 years rise in the survival. from 7% to 36% verus Radiotherapy only.

%Total survival
  • 27% Only Radiotherapy
  • 51% Radiotherpy+Hyperthermia
% 5 years survival
  • 7% Only Radiotherapy
  • 36% Radiotherapy + Hyperthermia

(van der Zee J, Gonzáles Gonzáles D, van Rhoon GC, van Dijk JDP, van Putten WLJ, Hart AAM: Comparison of radiotherapy alone with radiotherapy plus hyperthermia in locally advanced pelvic tumours: a prospective, randomized multicentre trial. Dutch Deep Hyperthermia Group. Lancet, 355: 1119-1125, 2000.)

(Gabbani M, Giudici S, Dall’Oglio S, Romano M, Franchi M, Maluta S: Clinical impact of adding hyperthermia in patients affected by locally advanced cervical cancer treated with chemo-radiotherapy: the experience of Verona multidisciplinary group. 10th International Congress on Hyperthermic Oncology, Munich, 2008.)


Clinical trials about the Radiotherapy plus Hyperthermia association

In 2004, a clinical group concensous was founded in Osaka (Kadota Fund International Forum, Kadota; Japan) and their conclusions were published in 2008 […] their documents showed a full recovery rate of 36% obtained with only Radiotherapy (0-50%) was almost duplicated with Radiotherapy plus Hyperthermia (69.5%;7-100%)

(van der Zee J, Vujaskovic Z, Kondo M, Sugahara T: The Kadota Fund International Forum 2004-clinical group consensus. Int J Hyperthermia, 24: 111-122, 2008.)


Head and Neck tumors

In 1994 Valdagni and Amichetti performed an Italian trial in phase III with 41 patients affected with stage IV inoperable head and neck cancer, revealed that Radiotherapy + Hypertermia combined raised the full response from a 41% to 83%, and a 5 years local control rate of 24% to 68%, and a total survival rate from 0% to 53%.

% of full response
  • 41% Only Radiotherapy
  • 83% Radiotherapy+Hyperthermia
% 5 years survival
  • 0% Only Radiotherapy
  • 53% Radiotherapy+Hyperthermia

Valdagni R, Amichetti M: Report of long-term follow-up in a randomized trial comparing radiation therapy and radiation therapy plus hyperthermia to metastatic lymph nodes in stage IV head and neck patients. Int J Radiat Oncol Biol Phys, 28: 163-169, 1994.


Melanoma

In 1996 a Danish phase II trial published by Overgaard and others with 70 patients with recidiv or metastasic melanoma obtained this results: full response 35% with Radiotherapy and 62% with Radiotherapy and Hyperthermia; 5 years disease free survival from 28% with Radiotherapy to 46% with Radiotherapy and Hyperthermia.

% Complete response
  • 35% Only Radiotherapy
  • 62% Radiotherapy+ Hyperthermia
% 5 years survival
  • 28% Only Radiotherapy
  • 46% Radiotherapy+ Hyperthermia

Overgaard J, Gonzalez Gonzalez D, Hulshof MC, Arcangeli G, Dahl O, Mella O, Bentzen SM: Hyperthermia as an adjuvant to radiation therapy of recurrent or metastatic malignant melanoma. A multicentre randomized trial by the European Society for Hyperthermic Oncology. Int J Hyperthermia, 12: 3-20, 1996.


Breast cancer

In 1996 an English phase III trial of Vernon and others, including 5 randomized trials and 306 patients affected with a local tumor, the results of the Radiotherapy and Hyperthermia arm raised the complete response rate from 41% to 59%, and the disease free survival from a 30%to 50% compared to the only Radiotherapy arm.

% Complete response
  • 41% Only Radiotherapy
  • 59% Radiotherapy+ Hyperthermia
% disease free survival
  • 30% Only Radiotherapy
  • 50% Radiotherapy+ Hyperthermia

Vernon CC, Hand JW, Field SB, Machin D, Whaley JB, van der Zee J, van Putten WL, van Rhoon GC, van Dijk JD, González González D, Liu FF, Goodman P, Sherar M: Radiotherapy with or without hyperthermia in the treatment of superficial localized breast cancer: results from five randomized controlled trials. International Collaborative Hyperthermia Group. Int J Radiat Oncol Biol Phys, 35: 731-744, 1996.


Esophageal Cancer

In 1996 a Wang and others Chinese trial, with 125 patients affected by esophageal cancer treated with Radiotherapy and Chemotherapy or without Hyperthermia reported 3 years survival doubled the increasing from 24% without Hyperthermia to 42% with Hyperthermia.

% 3 years survival
  • 24% Only Radiotherapy
  • 42% Radiotherapy + Hyperthermia

Wang J, Li D, Chen N: Intracavitary microwave hyperthermia combined with external irradiation in the treatment of esophageal cancer. Zhonghua Zhong Liu Za Zhi, 18: 51-54, 1996.


Glioblastoma Multiforme

In 1998 an American phase III trial published by Sneed and others, with 112 patients, showed general survival after 2 years was duplicate in patients with Brachyterapy + Hyperthermia versus patients with only Hyperthermia treatment.

Sneed PK, Stauffer PR, McDermott MW, Diederich CJ, Lamborn KR, Prados MD, Chang S, Weaver KA, Spry L, Malek MK, Lamb SA, Voss B, Davis RL, Wara WM, Larson DA, Phillips TL, Gutin PH: Survival benefit of hyperthermia in a prospective randomized trial of brachytherapy boost +/- hyperthermia for glioblastoma multiforme. Int J Radiat Oncol Biol Phys, 40: 287-295, 1998.


Superficial tumors

In 2001 a randomized trial in phase III published by Jones and other, with 109 patients affected with metastasic breast cancer in the chest wall, melanoma, or head and neck recidiv tumors obtained a 66% complete response in patients with Radiotherpy + Hyperthermia and a 42% in the arm without Hyperthermia. Results were even more impresive in patients who previously recieved Radiotherapy before, with a full response of 68% with Hyperthermia and a 24% without Hyperthermia.

% Complete response
  • 42% Only Radiotherapy
  • 66% Radiotherapy with Hyperthermia
% Complete response with previous Radiotherapy treatment
  • 24%Only Radiotherapy
  • 68% Radiotherapy + Hyperthermia

Van der Zee J, Vujaskovic Z, Kondo M, Sugahara T: The Kadota Fund International Forum 2004-clinical group consensus. Int J Hyperthermia, 24: 111-122, 2008.


Advanced Cervical cancer

A phase III trial submitted in April 2008 in Munich, in the Tenth Oncological Hyperthermia Congress, performed with 18 patients with Radiotherapy + Hyperthermia + Radiosensitive Cisplatin treatment, obtained a full response of 66% and a partial response of 32%. After 44 month of revisions, 50% had a disease free survival and 66% of survival. This triple treatment was well tolerated and with promising results.

Gabbani M, Giudici S, Dall’Oglio S, Romano M, Franchi M, Maluta S: Clinical impact of adding hyperthermia in patients affected by locally advanced cervical cancer treated with chemo-radiotherapy: the experience of Verona multidisciplinary group. 10th International Congress on Hyperthermic Oncology, Munich, 2008.


Retal advanced adenocarcinoma

A trial with intensified neo adjuvant Radiotherapy + Chemotherapy + Hyperthermia in 109 patients affected with rectal cancer T3-4, N0-1, M0 presented in 2003 in the Astro Meeting. The trial showed that adding Hyperthermia to 60-64 Gy of Radiotherapy is able to raise full and partial response in patients who had surgery. Also complete response increased in 6 patients that refused surgery, with 37 month revision. Subsequent trials in another group of 76 patients obtained a complete response in a 23.6% and partial response a 44.7%, and none change in 26.3% with an acceptable toxicity. Authors concluded that Chemotherapy and pre-operative Radiotherapy combined with Hyperthermia and resulted with low toxicity and a good full response and conservative surgical rates. Thermic therapy should be considered in future advanced rectal cancer trials.

Romano M, Maluta S, Cordiano C, Delaini GG, Genna M, Oliani C, Capelli P, Tomezzoli A, Manfrini C, Porcaro AB, Gabbani M, Chierego G: Pre-operative radio-chemotherapy plus regional hyperthermia in the treatment of advanced rectal cancer: experience with radiation dose escalation. Int J Radiat Oncol Biol Phys, 57: S386-387, 2003. 38. Maluta S, Romano M, Dall'Oglio S, Genna M, Oliani C, Pioli F, Gabbani M, Marciai N, Palazzi M: Regional hyperthermia added to intensified preoperative chemo-radiation in locally advanced adenocarcinoma of middle and lower rectum. Int J Hyperthermia, 26: 108-117, 2010.


Advanced anal canal tumors

A organ preservation viability trial in 13 patients treated with Radiotherapyy + Chemotherapy + Hyperthermia, presented in the 18th National Congress of AIRO, showed a 5 years disease free response of 54% compared to a 3 years total survival of 65% which was obtained in a EORTC trial, and a 5 years total survival of 69% in a RTOG trial. The disease free survival rate and good tolerance suggest to add Hyperthermia to our Radiotherapy and Chemotherapy protocols.

Palazzi M, Dall’Oglio S, Romano M, Maluta S: Is deep hyperthermia added to chemo-radiotherapy useful in the treatment of locally advanced anal cancer? Verona mono-institutional experience (2000-2006). Tumori, 7: S151, 2008.


Prostate cancer

In 2007 a prospective study in phase III, performed in 144 patients with high risk of advanced prostate cancer using Radiotherapy, Hyperthermia, and androgen deprivation (AD) with analog LH-RH and revisions during 52 months obtained an average total survival of 87,5% compared with scientific data, the results are satisfying , considering stages T2b-T4 N1 and the irregular AD therapy. In fact, AD was administered during 6 month following an initial protocol in a 52% of our patients while in other patients the AD therapy was the rejected or discontinued part. In 2009 a new trial, presented in the National SFRO Congress, with 20 patients treated with intensity modulated Radiotherapy in Pelvis plus radiation + Hyperthermia and AD in the prostatic zone a lower toxicity was observed in this patients than in other patients previously treated with only Radiotherapy.

Maluta S, Dall’Oglio S, Romano M, Marciai N, Pioli F, Giri MG, Benecchi PL, Comunale L, Porcaro AB: Conformational radiotherapy plus local hyperthermia in patients affected by locally advanced high risk prostate cancer: preliminary results of a prospective phase II study. Int J Hyperthermia, 23: 451-456, 2007. 41. Romano M, Palazzi M, Maluta S, Porcaro A: Radiothérapie conformationelle avec modulation d’intensité, hyperthermie profonde régionale et suppression androgénique totale chez des patients atteints d’une tumeur prostatique à haut risque, opérée ou non. Résultats préliminaires chez 20 patients. Cancer Radiothérapie, 13: 687, 2009.


Inoperable Pancreatic cancer

Since 2000 until 2008, 74 patients affected with locally advanced pancreatic cancer were treated in our department using Chemotherapy and Radiotherapy combined or not with Hyperthermia. Eight patients with distant metastasis were excluyed and 10 patients had a discontinuos monitoring. Of the 56 evaluable patients, 30 recieved Chemotherapy and Radiotherapy combined with Hyperthermia (group 1) and 26 patients recieved only Chemotherapy and Radiotherapy (group 0). In most cases the Chemotherapy consists in Gentamicin only. In 9 cases Gentamicin was combine with Fluorouracil (5-FU) and Oxaliplatin. Radiotherapy dose was 54Gy (51-56 range), combined with 1 session of Hyperthermia once a week in group 1. All patients were affected by a primary tumor, except 5 patients in group 1 and 7 in group 0, which had a recidive. After 12 months, 60% of the patients of group 1 and 50% of group 0 were alive, with a survival average of 14 versus 11 months, so they had an increasing of 3 months the group with Hyperthermia treatment. This raised to 9 months in cases of recidives and pancreas cancer metastasis (20 cases), where the survival average was of 14 months in the Hyperthermia group and 5 months in the group without Hyperthermia treatment (survival average 21,4 versus 10,4 months).

Chemotherapy + Radiotherapy combination was well tolerated, there was a toxicity raise in group 1, where Hyperthermia was added. Authors concluded that Hyperthermia combined with Chemotherapy and Radiotherapy is a promising form in advanced pancreatic cancer, specially in recidives and metastasis. It doesn’t raise the toxicity of the combined treatment. Considering the relative low number of patients of this trial and the lack of ramdomizing, a new phase III trial is needed to evaluate the effectiveness of Hyperthermia in pancreatic cancer.

42. Abstract book of ESHO 2010, Rotterdam, May 20-22, 2010.

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