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World J Gastrointest Oncol. Sep 15, 2021; 13(9): 1109-1120
Published online Sep 15, 2021. doi: 10.4251/wjgo.v13.i9.1109
Evidence based tools to improve efficiency of currently administered oncotherapies for tumors of the hepatopancreatobiliary system
Zoltan Herold, A Marcell Szasz, Magdolna Dank
Zoltan Herold, A Marcell Szasz, Magdolna Dank, Division of Oncology, Department of Internal Medicine and Oncology, Semmelweis University, Budapest H-1083, Hungary
Author contributions: Herold Z and Szasz AM searched the literature and drafted initial manuscript; Dank M provided further editing and comments; All authors have read and agreed to the published version of the manuscript.
Supported by The UNKP-20-4-I New National Excellence Program of the Ministry for Innovation and Technology from the source of the National Research, Development and Innovation Fund.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Magdolna Dank, MD, PhD, Professor, Division of Oncology, Department of Internal Medicine and Oncology, Semmelweis University, Tomo u. 25-29, Budapest H-1083, Hungary. dank.magdolna@med.semmelweis-univ.hu
Received: February 22, 2021
Peer-review started: February 22, 2021
First decision: April 19, 2021
Revised: April 29, 2021
Accepted: July 23, 2021
Article in press: July 23, 2021
Published online: September 15, 2021
Abstract

Hepatopancreatobiliary tumors are challenging to treat, and the advanced or metastatic forms have a very low 5-year survival rate. Several drug combinations have been tested, and new therapeutic approaches have been introduced in the last decades, including radiofrequency and heat based methods. Hyperthermia is the artificial heating of tumors by various biophysical methods that may possess immunostimulant, tumoricidal, and chemoradiotherapy sensitizer effects. Both whole-body and regional hyperthermia studies have been conducted since the 1980s after the introduction of deep-seated tumor hyperthermia techniques. Results of the effects of hyperthermia in hepatocellular and pancreatic cancer are known from several studies. Hyperthermia in biliary cancers is a less investigated area. High local and overall responses to treatment, increased progression-free and overall survival, and improved laboratory and quality-of-life results are associated with hyperthermia in all three tumor types. With the evolution of chemotherapeutic agents and the introduction of newer techniques, the combination of adjuvant hyperthermia with those therapies is advantageous and has not been associated with an increase in alarming adverse effects. However, despite the many positive effects of hyperthermia, its use is still only known at the experimental level, and its concomitant utilization in routine cancer treatment is not certain because of the lack of thorough clinical studies.

Keywords: Hyperthermia induced, Carcinoma hepatocellular, Cholangiocarcinoma, Gallbladder neoplasms, Pancreatic neoplasms

Core Tip: Adjuvant hyperthermia is beneficial in hepatopancreatobiliary cancers because of its direct and indirect antitumor effects. Increased treatment response, prolonged survival, and improved laboratory and quality of life data have been observed in several randomized and observational clinical trials of various hyperthermia methods. The use of hyperthermia in cancer care is not yet routine. In this review, the clinical data on hyperthermia in hepatopancreatobiliary tumors is summarized, focusing mainly on results that have the most clinical and research interest.