Statens beredning för medicinsk och social utvärdering
Hypertermibehandling (värmebehandling) vid cancer
Att utsätta tumörer för värme, så kallad hypertermibehandling, kan göra dem mer mottagliga för behandling eller ha en direkt verkande effekt genom att ta död på tumörvävnad Den antagna mekanismen vid hypertermibehandling är att tumören är mer känslig för värme än frisk omgivande vävnad och att hypertermi förstärker den cellskadande effekten av cellhämmande läkemedel (cytostatika) och strålbehandling. Det är dock oklart om hypertermibehandling har effekt utan att kombineras med cytostatika eller strålning.
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Frågor till SBU:s upplysningstjänst
Finns det vetenskapliga studier som undersökt om hypertermibehandling har effekt vid cancer, utan att kombineras med cellhämmande läkemedel eller strålbehandling?
Vilka systematiska översikter finns det som undersökt effekten av hypertermibehandling vid specifika cancerformer?
Frågeställare: Tillsynsläkare, Inspektionen för vård och omsorg
Sammanfattning SBU:s upplysningstjänst
Upplysningstjänsten har fokuserat på randomiserade kontrollerade studier (RCT:er) för frågeställningen om effekter av hypertermibehandling vid cancer, när den inte kombineras med cytostatika eller strålbehandling. Vi identifierade inga RCT:er för denna frågeställning.
För frågeställningen om specifika cancerformer identifierade Upplysningstjänsten 13 översikter på olika cancertyper där hypertermi i kombination med cytostatika och eller strålbehandling jämförts med enbart cytostatika och eller strålbehandling. Cancertyperna som studerats var: lokalt avancerad livmoderhalscancer (lokalt avancerad karcinom, sarkom), mag- och tarmcancer (matstrups-, rektal- och analcancer), pankreascancer, bröstcancer, blåscancer, prostatacancer, mjukdelssarkom, malignt melanom, germinalcellstumörer (från embryonala celler) och retinoblastom (cancer på ögats näthinna) hos barn och ungdom.
SBU har inte tagit ställning i sakfrågan eftersom vi inte har bedömt de enskilda studiernas kvalitet eller vägt samman resultaten. Här redovisar vi därför endast de enskilda författarnas slutsatser.
Detta är en uppdatering av upplysningstjänstsvaret "Effekt av hypertermibehandling (värmebehandling) vid cancer" från november 2013.
Litteratursökning
| The search result, usually found at the end of the documentation, forms the list of abstracts. au = Author; MeSH = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; this term only = Does not include terms found below this term in the MeSH hierarchy; :ti = Title; :ab = Abstract; :kw = Keyword; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; CDSR = Cochrane Database of Systematic Review; CENTRAL = Cochrane Central Register of Controlled Trials, “trials”; CRM = Method Studies; DARE = Database Abstracts of Reviews of Effects, “other reviews”; EED = Economic Evaluations; HTA = Health Technology Assessments | ||
| Search terms | Items found | |
| Population: | ||
| 1. | MeSH descriptor: [Neoplasms] explode all trees | 69 457 |
| 2. | "malignant":ti,ab,kw (Word variations have been searched) | 14 965 |
| 3. | cancer:ti,ab,kw (Word variations have been searched) | 141 162 |
| 4. | "metastases":ti,ab,kw (Word variations have been searched) | |
| Intervention: | ||
| 5. | hyperthermi*:ti,ab,kw (Word variations have been searched) | 1 761 |
| 6. | whole body:ti,ab,kw (Word variations have been searched) | 8 558 |
| 7. | "WBH":ti,ab,kw (Word variations have been searched) | 28 |
| Combined sets: | ||
| 8. | #1 or #2 or #3 or #4 | 172 830 |
| 9. | #8 and #5 | 822 |
| 10. | (#9 and #6) or #7 | 43 |
| Final I | #9 with Cochrane Library publication date from Jan 2013 to Dec 2019 | CENTRAL/499 |
| Final II | #10 with Cochrane Library publication date from Jan 2013 to Dec 2019 | CENTRAL/25 |
| /de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ab,ti = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | 'neoplasm'/exp OR 'neoplasm' AND neoplasm:ab,ti | 73 041 |
| 2. | 'metastasis'/exp OR 'metastasis' OR metastas*:ab,ti | 720 101 |
| 3. | 'cancer'/exp OR cancer:ab,ti | 4 014 687 |
| 4. | 'metastases'/exp | 596 656 |
| Intervention: | ||
| 5. | 'hyperthermic therapy'/exp OR 'hyperthermic therapy' | 24 336 |
| 6. | 'hyperthermia'/exp OR 'hyperthermia' OR hyperthermi*:ab,ti | 45 251 |
| 7. | 'malignant hyperthermia'/exp OR 'malignant hyperthermia' | 6 745 |
| 8. | 'whole body' OR WBH | 100 594 |
| Limits: | ||
| 9. | 'systematic review'/exp OR systematic:ab,ti OR meta:ab,ti | 553 733 |
| 10. | 'clinical trial'/exp OR 'clinical trial' OR (clinical:ab,ti AND trial:ab,ti) AND random*:ab,ti | 611 376 |
| 11. | 'controlled clinical trial'/exp | 709 431 |
| 12. | 'phase 3 clinical trial'/exp OR 'phase 4 clinical trial'/exp | 41 572 |
| 13. | [2013-2019]/py | |
| Final I | ((#1 OR #2 OR #3 OR #4) AND (#5 OR #6 OR #7) AND 9) AND 13 | 311 |
| Final II | ((#1 OR #2 OR #3 OR #4) AND (#5 OR #6 OR #7) AND 8) AND 13 | 78 |
| Final III | ((#1 OR #2 OR #3 OR #4) AND (#5 OR #6 OR #7) AND (#10 OR #11 OR #12)) AND 13 | 345 |
| Search terms | Items found | |
| Population: | ||
| 1. | (neoplas*) OR (Cancer) OR (metastas*) | 13 230 |
| Intervention: | ||
| 2. | MeSH DESCRIPTOR Hyperthermia, Induced EXPLODE ALL TREES | 226 |
| 3. | MeSH DESCRIPTOR Malignant Hyperthermia EXPLODE ALL TREES | 2 |
| 4. | (hyperthermia) | 123 |
| 5. | (whole body) or WBH | 156 |
| Combined sets: | ||
| 6. | #1 AND (#2 OR #3 OR #4) | 93 |
| 7. | #1 AND #5 | 72 |
| Limits: | ||
| 8. | * FROM 2013 TO 2019 | |
| Final I | #6 AND #8 | 26 |
| Final II | #7 AND #8 | 12 |
| The search result, usually found at the end of the documentation, forms the list of abstracts. ab,ti = abstract or title; exp = explosion searches, mapped searches of index terms; MeSH = term from the controlled vocabulary, including terms found below this term in mesh hierarchy; No index = free text search in all fields | ||
| The search result, usually found at the end of the documentation, forms the list of abstracts. au = Author; MeSH = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; this term only = Does not include terms found below this term in the MeSH hierarchy; :ti = Title; :ab = Abstract; :kw = Keyword; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; CDSR = Cochrane Database of Systematic Review; CENTRAL = Cochrane Central Register of Controlled Trials, “trials”; CRM = Method Studies; DARE = Database Abstracts of Reviews of Effects, “other reviews”; EED = Economic Evaluations; HTA = Health Technology Assessments | ||
| Search terms | Items found | |
| Population: | ||
| 1. | MeSH descriptor: [Neoplasms] explode all trees | 46 935 |
| 2. | "malignant":ti,ab,kw (Word variations have been searched) | 3 982 |
| 3. | cancer:ti,ab,kw (Word variations have been searched) | 49 294 |
| 4. | "metastases":ti,ab,kw (Word variations have been searched) | 7 312 |
| Intervention: | ||
| 5. | hyperthermi*:ti,ab,kw (Word variations have been searched) | 902 |
| 6. | whole body:ti,ab,kw (Word variations have been searched) | 3 238 |
| 7. | "WBH":ti,ab,kw (Word variations have been searched) | 13 |
| Combined sets: | ||
| 8. | #1 or #2 or #3 or #4 | 70 950 |
| 9. | #8 and #5< | 378 |
| 10. | (#9 and #6) or #7 | 20 |
| Final I | Cochrane rev=3/ Other rev=19/ Trials=335/ TA=18/Economic=3 |
378 |
| Final II | Cochrane rev=0/ Other rev=0/ Trials=19/ TA=1/Economic=0 |
20 |
| Search terms | Items found | |
| Population: | ||
| 1. | 'neoplasm'/exp OR 'neoplasm' AND neoplasm:ab,ti | 47 694 |
| 2. | 'metastasis'/exp OR 'metastasis' OR metastas*:ab,ti | 455 906 |
| 3. | 'cancer'/exp OR cancer:ab,ti | 3 519 387 |
| 4. | 'metastases'/exp | 377 423 |
| Intervention: | ||
| 5. | 'hyperthermic therapy'/exp OR 'hyperthermic therapy' | 12 838 |
| 6. | 'hyperthermia'/exp OR 'hyperthermia' OR hyperthermi*:ab,ti | 34 900 |
| 7. | 'malignant hyperthermia'/exp OR 'malignant hyperthermia' | 5 969 |
| 8. | 'whole body' OR WBH | 67 809 |
| Limits: | ||
| 9. | 'systematic review'/exp OR systematic:ab,ti OR meta:ab,ti | 269 871 |
| 10. | 'clinical trial'/exp OR 'clinical trial' OR (clinical:ab,ti AND trial:ab,ti) AND random*:ab,ti | 368 311 |
| 11. | 'controlled clinical trial'/exp | 451 567 |
| 12. | 'phase 3 clinical trial'/exp OR 'phase 4 clinical trial'/exp | 17 364 |
| Final I | (#1 OR #2 OR #3 OR #4) AND (#5 OR #6 OR #7) AND 9 | 187 |
| Final II | (#1 OR #2 OR #3 OR #4) AND (#5 OR #6 OR #7) AND 8 | 457 |
| Final III | (#1 OR #2 OR #3 OR #4) AND (#5 OR #6 OR #7) AND (#10 OR #11 OR #12) | 729 |
| /de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ab,ti = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase | ||
| The search result, usually found at the end of the documentation, forms the list of abstracts. ab,ti = abstract or title; exp = explosion searches, mapped searches of index terms; MeSH = term from the controlled vocabulary, including terms found below this term in mesh hierarchy; No index = free text search in all fields | ||
| Search terms | Items found | |
| Population: | ||
| 1. | (neoplas*) OR (Cancer) OR (metastas*) | 9 654 |
| Intervention: | ||
| 2. | MeSH DESCRIPTOR Hyperthermia, Induced EXPLODE ALL TREES | 178 |
| 3. | MeSH DESCRIPTOR Malignant Hyperthermia EXPLODE ALL TREES | 2 |
| 4. | (hyperthermia) | 96 |
| 5. | (whole body) or WBH | 130 |
| Combined sets: | ||
| 6. | #1 AND (#2 OR #3 OR #4) | 98 |
| 7. | #1 AND #6 | 1 |
| Final I | 98 | |
| Final II | #7 AND #8 | 1 |
Projektgrupp
2013
Detta svar är sammanställt av Göran Bertilsson, Jessica Dagerhamn och Jan Liliemark vid SBU. Det har granskats av professor Bengt Glimelius och professor emeritus Lars Olof Hafström.
2019
Detta svar är sammanställt av Miriam Entesarian Matsson (projektledare, produktsamordnare) samt Sara Fundell (projektadministratör) vid SBU. Det har granskats av professor emeritus Lars Olof Hafström.