Radiation therapy is often less than completely effective in controlling localized cancers. Hyperthermia (temperture greater than or equal to 42 degrees) used with radiation approximately doubles complete regression rates, but maximal effectiveness requires homogenous and selective heating and many tumors appear to be beyound the effective depth-heating characteristics of commercially available machines. Dr. Padmaker Lele has developed the scanned, intensity- modulated focused ultrasound (SIMFU) device which theoretically should be able to heat deep tumors relatively homogeneously and selectively, provided the beam portals can avoid bone or air. We intend to build this machine in the Radiation Therapy Department of the Dana-Farber Cancer Institute, simplify its rather complicated control programs, and evaluate its site-specific abilities to heat deep tumors. We will also test its non-scanning mode against the Clini-Therm Mark IX device for the heating of superficial tumors. In addition to machine testing we will conduct biological studies seeking to optimize the use of selected anticancer drugs with heat and radiation to control local-regional cancers. Patients with superficial tumors will be treated with weekly hyperthermia, daily radiation, and escalating doses of weekly Cisplatin. Following the Cisplatin dose-finding study, patients with superficial tumors will be randomized to heat and radiation plus or minus Cisplatin. Patients with deep tumors will be treated with heat and radiation; chemotherapy will be added in these patients only if efficacy is shown in superficial tumors.
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