Niloy R. Datta, Bharati M. Jain, Zatin Mathi, Sneha Datta, Satyendra Johari, Ashok R. Singh, Pallavi Kalbande, Pournima Kale, Vitaladevuni Shivkumar, and Stephan Bodis, Cancers 2022, Volume 14, Issue 2, Article No. 315; doi: 10.3390/cancers14020315
According to the Global Cancer Observatory, 59% of all cancers reported globally in 2020 were in the low-middle-income group countries (LMICs). Cancers of the breast, cervix, and head and neck, which constitute about a third of cancers in the LMICs, are largely in advanced stages and, thus, deemed inoperable. Chemoradiotherapy is usually advocated for treatment of these cases, but with limited success. Moderate hyperthermia at 40–44 °C, a multifaceted therapeutic modality, is a potent radiosensitizer and chemosensitizer that enforces immunomodulation akin to “in situ tumor vaccination”. Risk difference estimates from pairwise meta-analysis have shown that the local tumor control could be improved by 22.3% (p < 0.001), 22.1% (p < 0.001), and 25.5% (p < 0.001) in recurrent breast cancers, locally advanced cervix cancer (LACC), and locally advanced head and neck cancers, respectively, by adding hyperthermia to radiotherapy compared to radiotherapy alone. Furthermore, thermochemoradiotherapy in LACC have shown to reduce the local failure rates by 10.1% (p = 0.03) and decrease deaths by 5.6% (95% CI: 0.6–11.8%) compared to chemoradiotherapy alone. Hyperthermia could further be a cost-effective therapeutic modality, as the capital investment needed to set up a hyperthermia facility is relatively low. The safety and the benefits associated with the addition of hyperthermia to radiotherapy and/or chemotherapy for breast, cervix, and head and neck tumors has been well documented in various phase III randomized clinical trials and meta-analyses. As such, the inclusion of hyperthermia in the therapeutic armamentarium of clinical care, especially in the LMICs, may be a cost-effective and potentially game-changing addition to existing therapeutic options, especially for these tumor types.
The scientific and technical impact of the study can be summarized as: