The association of hyperthermia with chemotherapy is based on the phenomenon of heat interaction with cytostatics. The main mechanism of these interactions is to increase the concentration of cytostatics in the hyperthermic tumor, which can be attributed to:
(1) Increased perfusion in this area
(2) Increased cell membrane permeability
(3) Stimulation of intracellular metabolism
(4) Reducing reaction time under elevated temperature conditions.
The simplified classification of the types of hyperthermia interaction with chemotherapy depending on the type of drug proposed in 1999 by R. Issels is as follows:
⦁ Independent type – no drug / heat relationship is observed.
applies to: fluorouracil, methotrexate and taxanes
⦁ Additive type – hyperthermia increases the effectiveness of the drug
applies to: doxorubicin, gemcitabine, ifosfamide and etoposide
⦁ Synergistic type – heat and medicine are mutually reinforcing
applies to: cisplatin, carboplatin and bleomycin
Many studies also point to the fact that heat causes difficulties in the DNA repair process damaged by cell chemotherapy (Inhibition of DNA Repair Mechanism). A detailed interaction analysis can be found in A.L. Oei et al. from 2015 „Effects of hyperthermia on DNA repair pathways: one treatment to inhibit them all”.
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