
"According to an article published in Nature magazine ("Coley's Toxin's in Perspective", Vol 357, May 1992) there was a Dr. William B. Coley in NY in the 1890s who intentionally induced an erysipelas infection (streptococcal skin infection) in his sarcoma patients.  Eventually he mixed two different heat-killed bacteria to make what was termed "Coley's toxin" to give to the sarcoma patients DAILY over a period of weeks or months.  The fevers evidently were the forces at work, not the infections.  It seems he had some pretty good results.   Coley died in 1936.  The article goes on to mention some trials done by Dr. Demetri, along these lines, too...I think in an even broader array of cancer patients.  It seems that some kinds of sarcomas in particular responded the best to this treatment."  Kel in Orlando

"Hyperthermia dramatically increases the uptake of chemotherapy drugs by cancer cells. ... When the temperature of tumors is raised to high-fever level (hyperthermia), tumors become much more absorbent to chemotherapy drugs.  Increased blood flow is the body's natural response to heat, raising the uptake of drugs in tumor membranes.  As a result, hyperthermia "increases drug delivery and antitumor efficacy in patients," ...  Once drugs are delivered, hyperthermia can also be used as an activator to accelerate drug chemical reactions.  Hyperthermia is further demonstrating a role as a valuable companion therapy when chemotherapy drugs are injected into the blood in encapsulated form (liposomes)... when a liposome-encapsulated drug is used in combination with hyperthermia, tumor drug penetration greatly increases.  According to a research team from Munich, this boost in the effectiveness of chemotherapy is good news for victims of high-risk soft-tissue sarcomas, ..."[2*]

"  ... Some researchers advocate heating just one region of the body, but Dr. Bull at The University of Texas-Houston Health Science Center   is testing whole-body hyperthermia. The study is being conducted in patients with cancer of the colon, stomach, and pancreas.  Although the number of study participants whose tumors completely disappeared remains small, ...up to 50 percent of patients in the study who undergo both hyperthermia and chemotherapy have seen their tumors either shrink or stop growing. In pancreatic cancer, the partial response rate is as high as 70 percent."[1*]


Hyperthermia is a technique useful in loco-regional control.  It seems to be most effective, when combined with other treatments like surgery, chemotherapy and/or radiation, in preventing local recurrence, if the surgical resection margins are clear.  Local use does not prevent distant metastasis.  In certain circumstances, used along with other types of treatment, hyperthermia might contribute to an increase in survival time.  

Generally, local recurrence rates are influenced by tumor site, type of trial, maximum tumor temperature, and local toxicity, whereas overall survival is influenced by the presence of metastasis, tumor grade, and response to treatment. [26]

NOTE: Many of these studies are referring to SARCOMAS, not leiomyosarcoma.  However, leiomyosarcoma has shown response to hyperthermic treatment. 

Hyperthermia [heating tissue to higher than normal body temperatures] greater than or equal to 42 degrees C is tumoricidal in vitro and in many animal models. [167] Hyperthermia is an older technique, used since the 1970's in combination with radiation to control tumor growth in hypoxic malignant tumors of low radiation sensitivity, especially in superficial and shallow tissue regions. [178] It was well tolerated without serious side effects. [178] Later, hyperthermia was also included with chemotherapy.  Hyperthermia can be local [superficial or deep], regional, or with whole body involvement.  So it can be used to treat superficial tumors, or deep ones.  It can be used to treat pelvic or abdominal sarcomatosis by regional treatment.   It can be accomplished with isolated limb perfusion of extremities. Even whole body treatment can be done. The technical choices of how to achieve the hyperthermia vary with the location.  It is usually combined with other modalities of therapy, usually chemotherapy or radiation.

In 1981, with development of a radiofrequency device that provided safe hyperthermia, to any depth without surface tissue injury, a study was done evaluating the effects of hyperthermia on advanced human sarcomas.  "Intratumor temperatures greater than or equal to 42 degrees C [about 108 deg F] were observed in all tumors, with virtually no normal tissue injury. ... [The treatment] resulted in significant tumor necrosis and pain relief in some patients. Hyperthermia of advanced sarcomas is possible with little host toxicity and may be of potential therapeutic benefit." [167]

Another early study: "Soft tissue sarcomas continue to present problems with both local control of disease and death from distant metastases after accepted surgical therapy. Multimodality management has been established in the literature to be superior to traditional therapy of wide excision or amputation .... One-third of the patients presented with local recurrent disease after unsuccessful primary treatment. Over-all local recurrence for all patients treated by a combination of the aforementioned modalities was 3.4 per cent at two years and 11.1 per cent at five years. ... Not only are the treatment results with regional hyperthermic perfusions excellent for both primary and locally recurrent sarcomas of the extremities, but limbs previously considered unsalvageable can be spared." [150] 

From another early study, "Bone and soft tissue sarcomas are good targets for hyperthermia combined with radiotherapy and chemotherapy. Some tumors indicated for this study were too large to heat with the present heating apparatus." But they got a 65% response rate with heating to 42 deg C [92] 

Leiomyosarcoma shows high levels of chemoresistance to many chemotherapy agents. [101] A 1994 study concluded "These findings suggest that ...when ... leiomyosarcoma tumors show resistance to antitumor drugs, then resection at the time of initial exploration and combined modalities, including radiation and hyperthermia, should be considered." [101] 
