
<b>Hyperthermia with/without Radiation</b>    

Complications directly attributable to hyperthermia when used in conjunction with radiation are usually second- or third-degree burns, blistering, areas of superficial soft tissue necrosis, and possible fistula formation.  The hyperthermia complications were generally not severe and either healed readily or were excised at the time of surgical resection of the primary tumor.  The persistent complications noted included induration and fibrosis, ulceration at the site of prior tumour and ulceration in normal tissue. [27, 74, 110,165]   Height of tissue temperature attained had a slight association with increased complications.  "Macroscopic tumours had greater incidence of complications than for microscopic residual disease.  The rate and type of persistent and/or late complications seen following combined radiation and hyperthermia did not appear to dramatically differ from those that would be anticipated from irradiation alone in this patient population, with the exception of an increased incidence of areas of induration and tumour necrosis." [110]

<b>Intraoperative Microwave Hyperthermia</b>
With intraoperative microwave hyperthermia the complications can include infection, subsequent pathological fracture of the devitalized bone. [72]

<b>Isolated Limb Perfusion</b>
During hyperthermic isolated limb perfusion, common side effects are redness and edema, skin reactions, and transient nerve dysfunction. [126]  When chemotherapy agents are perfused, there can be leakage of the chemotherapy agent into the systemic circulation can occur.  [6] There can also be neuromuscular toxic effects, worse with pre-existing neuropathy.  [24] Isolated limb perfusion patients might have atrophy, and/or chronic edema [swelling due to fluid accumulation]. [29] Vascular complications after isolated limb perfusion are rare, consisting mainly of clots at the arterial site where the artery was entered, and can be successfully treated by prompt operation to remove the clot.  It happens in women, possibly because of the smaller size of their arteries.  Therefore, close observation of the peripheral circulation after ILP is necessary. [42]

<b>Whole Body Hyperthermia</b>
Whole-body Hyperthermia [WBH] combined with chemotherapy can be shown to increase tumor cell death without increasing bone marrow toxicity. [23, 170] However, there can be a treatment-limiting problem with nephrotoxicity [kidney damage].   ICE treatment [ifosfamide, carboplatin, etoposide] can cause temporary kidney damage, but if given with Whole Body Hyperthermia, this damage PERSISTS.  Extracorporeal WBH [where blood was warmed outside the body] was more toxic to the kidneys than radiant-heat-induced WBH. [23] 

WBH  in combination with chemotherapy also can cause an acute systemic inflammatory response resulting in Multiple Organ Dysfunction Syndrome [in this case, brain dysfunction, low blood pressure, respiratory failure, renal dysfunction]  [30]  WBH alone can also cause transient thrombocytopenia in all patients, non-cardiogenic pulmonary edema, and mild hypotension. [113]
