Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “THERMOTHERAPY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed1996

The role of an advanced thermotherapy device in prostatic voiding dysfunction.

OBJECTIVES: To investigate the efficacy of an advanced transurethral thermotherapy (TUMT) device (T3, Urologix) using urodynamic analysis in addition to the standard evaluation protocol in patients with symptomatic benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: Fifty men with symptomatic BPH were assessed using the AUA symptom score, uroflowmetry and ultrasonography (to determine prostatic volume and residual urinary volume) before and 6 weeks, 3, 6 and 12 months after thermotherapy. TUMT was delivered using a focused microwave energy system for 1 h in each patient, treated on an out-patient basis. Video pressure flow studies with advanced urodynamic analysis were also performed before and 3 months after treatment. RESULTS: The mean AUA symptom score decreased by 63%, the mean peak flow rate increased by 64% and the post-void residual volume decreased by 30% 3 months after treatment; this improvement was maintained at one year after treatment. Advanced urodynamic analysis showed that 52% of the patients had a decreased severity of obstruction. Furthermore, the efficiency of detrusor contraction improved in 86% of the patients. The improvement in the symptom score, flow rate and residual urine was significantly better in patients with marginal obstruction than in patients with unequivocal obstruction. CONCLUSION: Urodynamic analysis can predict the treatment outcome of TUMT and the results of thermotherapy are significantly better in patients with marginal prostatic bladder outflow obstruction.

Aged↗
PubMed2000

[Fusion of CT and PET data: methods and clinical relevance for planning laser-induced thermotherapy of liver metastases].

AIM: Catheter-placement in liver metastases is difficult when the lesions are not visible on plain images. We evaluated the use of image fusion using CT and PET data, providing information on anatomy and liver lesions, respectively. METHODS: Plain CT of the liver and whole body FDG-PET were performed in 28 patients with colorectal carcinoma in preparation for laser-induced thermotherapy. Fusions of image data and 2D-visualisation were performed and evaluated with regard to quality of the registration, number of detected lesions and influence of the procedure on laser-induced thermotherapy. Image fusion was performed using an algorithm which was developed by our group. RESULTS: 84 focal liver lesions were visible on CT, 107 on PET images. This means that CT guided catheter placement would have to be performed "blindly" in 23 lesions. In 6 patients previously unknown extra-hepatic tumor deposits were seen on PET images (local recurrence, 2 extrahepatic metastases, 2 second primaries). CONCLUSION: Hot spots from metastases, which are difficult to locate on PET images alone, may be identified on images generated by fusion of CT and PET data. These images facilitate an interventional approach to liver lesions which are not visible on plain CT. As PET allows for whole body screening, it helps identifying patients who would not profit from laser-induced thermotherapy.

Algorithms↗
PubMed1998

Integrality of benign prostatic hyperplasia tissues after transurethral thermotherapy evidenced by transmittance fourier transform infrared spectroscopy combined with thermal analyzer.

Transmittance Fourier transform infrared microspectroscopy combined with differential scanning calorimetry was used to simulate the clinically transurethral thermotherapy of benign prostatic hyperplasia (BPH) by in vitro isothermal determination. The simulative study to the thermotherapy of epithelium or stroma in BPH tissue was performed at 47 degrees C for 3 h, like clinical therapy. Whether thermal treatment can induce changes in the secondary structure of epithelium or stroma in BPH tissue was investigated. The results indicate that the epithelium and stroma in BPH tissue had different protein secondary structures, due to the different compositions of the epithelium and stroma. No significant change was evidenced in secondary structure for each sample either before or after isothermal study, suggesting the integrality and safety of BPH thermotherapy in a 47 degrees C for 3 h treatment course.

Calorimetry, Differential Scanning↗
PubMedDate not supplied

Subthreshold transpupillary thermotherapy for subfoveal occult choroidal neovascularization secondary to age-related macular degeneration.

PURPOSE: To describe the long term outcome of patients with subfoveal, occult choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD) treated with subthreshold transpupillary thermotherapy. METHODS: 82 eyes of 82 consecutive patients with subfoveal occult CNV secondary to AMD were treated with subthreshold transpupillary thermotherapy. Best corrected visual acuity, fundus photography, fluorescein and indocyanine green angiography were performed. RESULTS: All patients have been followed for at least 24 months. At the final follow-up visit, 75.6% of patients had stable or improved visual acuity and 24.4% had worsened visual acuity. No overtreatment side effects were found. CONCLUSION: Subthreshold transpupillary thermotherapy seems effective in stabilizing visual acuity in patients affected by occult, subfoveal CNV even on a long-term basis.

Aged↗
PubMed2003

Application of external microwave thermotherapy in urology: past, present, and future.

The excellent clinical results of transurethral microwave thermotherapy (TUMT) for the treatment of symptomatic benign prostatic hyperplasia (BPH) gave to TUMT the leading position among the microwave thermotherapy modalities available for the treatment of different urologic conditions. Research in TUMT has focused on operating software, temperature monitoring, intraprostatic heat distribution, cell-kill calculations, and correlations with clinical variables. Randomized comparisons of TUMT with other established therapies for BPH, including transurethral resection, have facilitated the evaluation of the clinical outcome, durability, morbidity, and costs of the treatment. The applications of microwave thermotherapy in other urologic diseases are also presented in this review.

Attitude of Health Personnel↗
PubMed2001

Ex vivo evaluation of novel miniaturized laser-induced interstitial thermotherapy applicators for effective small-volume tissue ablation.

RATIONALE AND OBJECTIVES: For effective small-volume tissue ablation in clinical and experimental settings, smaller laser-induced interstitial thermotherapy (LITT) applicator designs are required. The aim of this study was to compare the ablation properties of recently developed ultrasmall and small to standard LITT applicators. METHODS: Laser-induced interstitial thermotherapy was performed on liver samples using ultrasmall, small, and standard LITT applicators. Thermotherapy was monitored by magnetic resonance imaging, and lesion sizes were measured for each image. True lesion sizes were then determined macroscopically and by histology. RESULTS: For continuous laser application over 5 minutes, maximum power settings were 5 W for the ultrasmall and small applicators and 10 W for the standard applicator. Given identical LITT settings, lesion volume measured by magnetic resonance imaging was significantly larger and histological tissue damage was more severe with the ultrasmall and small applicators than with the standard applicator. CONCLUSIONS: Small and ultrasmall LITT applicators can be used for effective tissue ablation of small target volumes in experimental and clinical applications.

Animals↗
PubMed1998

Intraprostatic temperature monitoring during transurethral microwave thermotherapy for the treatment of benign prostatic hyperplasia.

PURPOSE: We evaluated whether the results of transurethral microwave thermotherapy improve using high intraprostatic temperatures of 55C or greater. MATERIALS AND METHODS: We accrued 30 men 58 to 85 years old (mean age 69) from the waiting list for transurethral prostatic resection in whom maximum urinary flow was less than 13 ml. per second and Madsen score was greater than 8. According to the Abrams-Griffith nomogram all but 1 patient had obstruction. Before treatment 3 thin temperature probes, each containing 5 sensors in a row, were introduced into the prostate from the perineum and positioned using transurethral ultrasound guidance. The microwave power of the transurethral microwave thermotherapy equipment was set based on the actual temperature in the prostatic tissue. A temperature of at least 55C and often more than 60C was reached at the hottest spot. Treatment duration was 1 hour. Postoperatively an indwelling catheter remained in place for 2 weeks. Patients were followed for 6 months with the first followup after 3 months. RESULTS: At the 3-month followup mean maximum urinary flow had increased from 7.4 to 12.5 ml. per second and the mean Madsen score had decreased from 12.6 to 2.9. At the 6-month followup mean maximum urinary flow was 12.2 ml. per second and the mean Madsen score was 3.4. Using pressure-flow data we divided the patients into responders and nonresponders. In the 18 responders maximum urinary flow had increased from 7.2 to 14.6 ml. per second (103%), the Madsen score had decreased from 12.5 to 1.4 (89%) and detrusor pressure had decreased from 9.2 to 6 kPa. (35%). CONCLUSIONS: High energy transurethral microwave thermotherapy relieved bladder outlet obstruction in 60% of the patients and had a good effect on symptoms. Compared with a previous multicenter study with 40% responders, using the same criteria there were 60% responders in our series. Our results indicate that better control of intraprostatic temperature provides better results, approaching those after transurethral prostatic resection.

Aged↗
PubMed2001

Transpupillary thermotherapy of subfoveal occult choroidal neovascularization.

Choroidal neovascularization secondary to age-related macular degeneration is a leading cause of vision loss in adults. Although most patients present with occult CNV, treatment has focused on the small percentage of eyes with well-delineated, classic CNV. Transpupillary thermotherapy is a recent advancement in the management of occult CNV. Transpupillary thermotherapy acts in a subthreshold manner by slightly raising the choroidal temperature. A recent pilot study demonstrated that 56% of treated eyes remained stable one year after treatment with only 25% losing two lines of visual acuity. The TTT4CNV study will further evaluate the effectiveness of transpupillary thermotherapy in a randomized, double-blind trial.

Choroidal Neovascularization↗
PubMed2001

Yellow dye laser thermotherapy of choroidal neovascularisation in age related macular degeneration.

AIM: A pilot study of the feasibility of using dye laser thermotherapy (LTT) at a subcoagulation temperature to occlude newly formed vessels in patients with age related macular degeneration (AMD). METHODS: Choroidal neovascularisation (CNV) in 24 eyes with exudative AMD was treated with a continuous wave yellow laser at 578 nm. Parameters were an exposure time of 2 or 5 seconds, a spot size of 750 or 1000 microm, and a laser power of 100-200 mW. The clinical end point was a greyish discoloration at the treatment site. The effect of thermotherapy was documented by ophthalmoscopic and fluorescein angiographic examination. The follow up after LTT was 4-16 months, mean 5 months. RESULTS: LTT resulted in total occlusion of newly formed vessels in 15 eyes (62.5%). Neovascular outgrowth within 6 weeks and recurrences 2-4 months after LTT were observed, each in three eyes. In six of the nine eyes with occlusion of CNV without recurrence the choriocapillaris remained perfused; in two eyes only the large choroidal vessels remained perfused. In six eyes pigmentary changes were the only ophthalmoscopic and fluorescein angiographic signs of treatment. The effect of LTT is rather unpredictable. CONCLUSION: CNV in AMD can effectively be treated by yellow dye laser thermotherapy with preservation of choroidal perfusion. The technique requires dosimetric adaptation.

Choroid↗
PubMed2004

Focused microwave phased array thermotherapy for ablation of early-stage breast cancer: results of thermal dose escalation.

BACKGROUND: Tumor ablation as a means of treating breast cancer is being investigated. Microwave energy is promising because it can preferentially heat high-water-content breast carcinomas, compared to adipose and glandular tissues. METHODS: This is a prospective, multicenter, nonrandomized dose-escalation study of microwave treatment. Thermal dose was measured as (1) thermal equivalent minutes (cumulative equivalent minutes; CEM) of treatment relative to a temperature of 43 degrees C and (2) peak tumor temperature. Microwaves were guided by an antenna-temperature sensor placed percutaneously into the tumor. Outcomes measured were pathologic response (tumor necrosis) side effects. RESULTS: Twenty-five patients (mean age, 57 years) were enrolled. The mean tumor diameter was 1.8 cm. Tumoricidal temperatures (>43 degrees C) were reached in 23 patients (92%). Tumor size was unchanged after thermotherapy (P = not significant). Pathologic necrosis was achieved in 17 (68%) patients. Complete necrosis of the invasive component was achieved in two patients. One hundred forty CEM is predictive of a 50% tumor response, and 210 CEM is predictive of a 100% tumor response (P =.003). Univariate linear regression predicts that peak tumor temperatures of 47.4 degrees C and 49.7 degrees C cause a 50% tumor response and a 100% tumor response, respectively. CONCLUSIONS: Thermotherapy causes tumor necrosis and can be performed safely with minimal morbidity. The degree of tumor necrosis is a function of the thermal dose. Future studies will evaluate the impact of high doses of thermotherapy on margin status and complete tumor ablation.

Breast Neoplasms↗
PubMedDate not supplied

Temperature control and light penetration in a feedback interstitial laser thermotherapy system.

The aim of this study was to describe the performance of a closed loop interstitial laser thermotherapy system in processed liver and to demonstrate its suitability for treating a vascularized tumour in vivo. The thermotherapy system consisted of an Nd: YAG laser and a temperature feedback circuit including an automatic thermometry system and thermistor probes. Experiments in processed liver were performed with a sapphire probe and temperature control at a distance of 10 mm. In most experiments at 1-2 W, and in half of the experiments at 3 W, there was no carbonization, a moderate change in the light penetration and excellent control of the temperature. In experiments with output powers of 4-5 W there was carbonization with rapid deterioration of light penetration and impaired control of the temperature. Carbonization affected the distribution of temperatures, which were lower below, and higher above, the laser tip in experiments with carbonization as compared to experiments without carbonization. Treatment of an adenocarcinoma implanted into rat liver was performed at 2 W with a bare fibre and without blood inflow occlusion. The feedback thermistor probe was placed 3 mm outside the margin of the tumour (largest diameter 9.5 +/- 0.3 mm (mean +/- SEM)). Temperature control and light penetration characteristics were similar to those found in vitro. No tumour could be demonstrated at sacrifice 6 days later. It is concluded that a closed loop feedback system can produce stable and reproducible local hyperthermia, that it performs better when carbonization is avoided and light penetration is preserved and that it has a great potential for interstitial thermotherapy of malignant tumours.

Animals↗
PubMed1998

Current status of transurethral thermotherapy at the Mayo Clinic.

With the ever-expanding elderly population in the United States, benign prostatic hyperplasia (BPH) has become a widespread condition. Although surgical intervention (open prostatectomy and transurethral resection of the prostate) was the typical management approach for BPH in the past, other options currently include drug therapy and transurethral thermotherapy, a minimally invasive procedure that involves the targeting of heat deep within the prostate transition zone while cooling the surrounding anatomic structures with circulating water. Two thermo-therapy-devices--the Prostatron and the T3 transurethral thermoablation therapy catheter--have been studied in randomized controlled clinical trials at the Mayo Clinic. Both devices were shown to be effective in a substantial subset of patients with BPH: symptom scores decreased, peak urinary flow rates increased, and total serum prostate-specific antigen levels increased, an indication of destruction of adenomatous tissue. All patients were able to complete the treatment without the need for general or regional anesthesia, and thermotherapy was associated with few postprocedural events. Although this therapeutic strategy is currently used selectively in patients with lateral lobe prostatic adenoma, improvements in technology and understanding of the thermoregulatory properties of the prostate should broaden the application of thermotherapy devices in the management of BPH.

Adult↗
PubMed2005

[Transpupillary thermotherapy in the primary management of choroidal melanoma].

OBJECTIVE: To determine if primary transpupillary thermotherapy can achieve local remission of choroidal melanoma. Secondary objectives were to determine safety of treatment, visual acuity and evaluate complications. The long term objective was to evaluate the impact of treatment on survival without metastatic disease. METHODS AND PATIENTS: Thirty-one patients with small choroidal melanomas were treated with transpupillary thermotherapy between 1st December 1997 and 15th June 2001. These patients satisfied predetermined inclusion criteria. To perform the treatment, an infrared diode laser (810 nm) with emission adapted for use with a surgical microscope was used, applying the treatment through a Mainster contact lens. In most patients, the diameter of the irradiation beam was 2 mm, the exposure time was 1 minute and the level of energy given was between 250 and 800 mW. RESULTS: Of 31 patients treated, 26 patients were evaluated in this study. With a mean follow-up of 23.13 months (standard deviation (S.D.): 15 and median: 18.6 months), tumoral remission was observed in 50% of the evaluated tumors. The post-treatment visual acuity in the patients with tumoral remission was better than in patients with treatment failure (P = 0.004). CONCLUSIONS: Primary treatment of choroidal melanomas with transpupillary thermotherapy may be a good therapeutic option in selected cases.

Adult↗
PubMed1994

[Transurethral microwave thermotherapy for benign prostatic hyperplasia: a 1-year follow-up study].

The authors studied a 1-year effect of transurethral microwave thermotherapy (TUMT) using the PROSTCARE apparatus (Bruker Spectrospin Wissembourg, Frace) on 35 patients with symptomatic benign prostatic hyperplasia (BPH). The device is equipped with a unique non-invasive system "radiometry" for the measurement of the intraprostatic temperature to regulate the microwave emission power and to eliminate classic surface controls. All of the 35 patients received a single thermotherapy session (60 minutes), the average intraprostatic temperature was 43.6 +/- 1.2 degrees C (mean +/- SD) and the average power output was 43.9 +/- 4.1 Watt. The clinical effects were evaluated at 2 months, 6 months and 1 year after TUMT by a specially designed score scale for subjective symptoms and objective findings as compared with the pretreatment score. Assuming that more than a 25% reduction of the total score indicates "effective", 71.4%, 71.4, and 48.6% of the treatments remained effective at 2 months, 6 months, and 1 year after TUMT, respectively. The maximum prostatic urethral pressure profile decreased from 64.1 +/- 17.1 to 51.7 +/- 15.6 cmH2O (p < 0.05) at 2 months after TUMT. The thermotherapy by PROSTCARE is effective in approximately 50% of patients at least 1 year and there were no major complications associated with TUMT during the follow up period.

Aged↗
PubMed1995

[How does thermotherapy effectively work on benign prostatic hyperplasia--an experimental study].

Isometric contractile force of rabbit prostatic tissue in response to electric field stimulation (EFS), KCl, and phenylephrine were measured at incubation temperature of 37 degrees C, before and after thermal exposure to 42 degrees C, 45 degrees C, 48 degrees C and 50 degrees C for 30 minutes. The contractile force in response to EFS decreased after thermal exposure above 45 degrees C, and the contractile force in response to KCL or phenylephrine decreased after thermal exposure above 48 degrees C. All the contractile response abolished after thermal exposure to 50 degrees C. The results indicate that the nerve is more hear-sensitive than the smooth muscle in the prostate. Histological examination revealed shrinkage of cell body and dark staining of nuclear chromatin of the smooth muscle cells after thermal exposure above 48 degrees C. The same histological change of the smooth muscle as well as degenerative change of the nerve cells was observed on the prostate 3-7 months after clinical thermotherapy. From these results, it is suggested that clinical effect of thermotherapy is brought about from both neural and muscular damage of the prostate. Since the least temperature to cause an irreversible tissue damage ranges from 48 degrees C through 50 degrees C, we believe it is ideal to heat the prostate around 50 degrees C to obtain a good clinical effect of thermotherapy on benign prostatic hyperplasia as a minimum invasive treatment.

Aged↗
PubMed1995

[Transurethral radiofrequency thermotherapy for benign prostatic hyperplasia].

Transurethral radiofrequency thermotherapy was performed in 38 patients with benign prostatic hyperplasia using Thermex II (Direx) between December 1992 and June 1993, and its clinical efficacy was evaluated by analysing the subjective and objective responses following the treatment. Each patient was treated with an indwelling 16 Fr balloon catheter with electrode, in a single session of 90 minutes at 47-47.5 degrees C. The clinical efficiency was evaluated by total of AUA symptom score and objective findings in terms of maximum flow rate 12 weeks after treatment. The symptom score improved from 15.4 +/- 4.9 (mean +/- SD) to 7.3 +/- 5.2 25% or more improvement was found in 80% (20/25) of patients. No significant change was found in average of maximum flow rate before and after treatment, which were 8.9 +/- 4.1 (ml/sec) and 9.2 +/- 3.3, respectively. During the treatment no severe adverse effect except sense of heat and urgency was detected. Posttreatment urinary retension was found in 9 patients and catheters were indwelled in eight of them for a few days and prostatectomy was performed in one patients after 8 weeks of treatment. In four patients prostatectomy was performed between one day and 8 weeks after thermotherapy and histrogical effect on the resected specimen was examined. In the prostatic urethra, hemorrhage and inflammatory change were observed. However, in the prostatic tissue there was no necrotic region. Transurethral radiofrequency thermotherapy is safe and easy and it may be one of the useful treatments for benign prostatic hyperplasia.

Aged↗
PubMed2001

Is chronic lymphocytic leukemia a contraindication for radon and thermotherapy?--a case report.

A growing number of patients presenting for radon-thermotherapy have a history of malignant disease. The question as to whether malignancies in general are a contraindication for radon treatment or mild hyperthermia during spa therapy is still a subject of controversy. We report a patient with osteoarthritis and a frozen shoulder who repeatedly underwent speleotherapeutic radon and hyperthermia treatment in the gallery of the Gasteiner Heilstollen, Austria, despite concomitant chronic lymphocytic leukemia (B-CLL, Rai stage 0). After nine courses of radon-thermotherapy over eight years, no apparent negative impact on CLL was noted. The purpose of this case report is to encourage discussion as to whether CLL or other past or present malignancies must be considered a contraindication for spa treatment such as radon-thermotherapy.

Austria↗
PubMed2001

[What to think of "adjuvant" or "neoadjuvant" thermotherapy in the treatment of uveal melanomas?].

Before 810Nm laser thermotherapy has been usd for uveal melanoma, several authors especially in Essen (Germany) were asking themselves about the possibilities of xenon arc or argon laser effects on uveal melanomas. High rates of recurrences due to the non penetration of therapeutic light till the sclera had led to the conception of using adjuvant thermotherapy associated with radiotherapy, through microwaves, ultrasounds or ferromagnetic seeds. In Leyden (Netherlands) was proposed the use of 810Nm laser diode initially as an adjuvant to radiotherapy and later on as primary isolated treatment ("neo adjuvant" TTT), especially for small tumours located in the posterior pole (juxta-papillary tumours). TTT used alone should not be proposed for tumours of inital height of more than 3,5 to 4mm. "Neo adjuvant" thermotherapy finds some other indications like decompensated naevi responsible for macular detachment. Bigger peripheral tumours stabilized by protonbeam therapy but associated with persistent detachment after the 12(th) month could be treated with "adjuvant" TTT. Finally the importance of the quality of the tumour edges treatment should be emphasized.

Animals↗