Mild hyperthermia, local heating of the tumour up to temperatures <43 °C, has been clinically applied for almost four decades and has been proven to substantially enhance the effectiveness of both radiotherapy and chemotherapy in treatment of primary and recurrent tumours. Clinical results and mechanisms of action are discussed in this review, including the molecular and biological rationale of hyperthermia as radio- and chemosensitizer as established in in vitro and in vivo experiments. Proven mechanisms include inhibition of different DNA repair processes, (in)direct reduction of the hypoxic tumour cell fraction, enhanced drug uptake, increased perfusion and oxygen levels. All mechanisms show different dose effect relationships and different optimal scheduling with radiotherapy and chemotherapy. Therefore, obtaining the ideal multi-modality treatment still requires elucidation of more detailed data on dose, sequence, duration, and possible synergisms between modalities. A multidisciplinary approach with different modalities including hyperthermia might further increase anti-tumour effects and diminish normal tissue damage.

中文翻译：

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热疗作为放射和化学增敏剂的分子和生物学原理。

轻度热疗，将肿瘤局部加热至<43°C，已在临床上应用近四年，并已被证明可显着提高放疗和化疗治疗原发性和复发性肿瘤的有效性。本综述讨论了临床结果和作用机制，包括体外和体内实验中确定的热疗作为放射和化学增敏剂的分子和生物学原理。已证实的机制包括抑制不同的 DNA 修复过程、（中）直接减少缺氧肿瘤细胞部分、增强药物摄取、增加灌注和氧气水平。所有机制均显示出不同的剂量效应关系和不同的放疗和化疗最佳调度。所以，获得理想的多模式治疗仍需要阐明有关剂量、顺序、持续时间和模式之间可能的协同作用的更详细数据。包括热疗在内的不同方式的多学科方法可能会进一步增加抗肿瘤作用并减少正常组织损伤。