The role of capacitive hyperthermia as an adjunct treatment in oncology: a systematic review of randomized phase III trials.

Clinical Snapshot

Key Findings

• P Value: Not reported at the systematic review level

• Effect Size: Not reported — no pooled effect sizes or hazard ratios provided; results presented as narrative synthesis only

• Primary Outcome: Capacitive hyperthermia combined with RT and/or CT improved local control (LC) and overall survival (OS) in 3 of 5 cervical cancer trials; marked improvement in tumour response (TR) rates in both head and neck cancer trials; no benefit observed in non-small cell lung cancer or in one large multicentre cervical cancer trial

• Nnt Or Sensitivity: Not calculable from available data; no NNT, hazard ratio, or response rate differences with confidence intervals are provided in the abstract

• Confidence Interval: Not reported

Clinical Application

Capacitive hyperthermia requires specialised equipment (e.g., Thermotron RF-8, BSD systems) and trained personnel, limiting availability to tertiary and quaternary oncology centres. Treatment delivery requires multiple sessions concurrent with RT or CT. Thermal dosimetry and quality assurance are technically demanding. The mild-to-moderate toxicity profile reported is clinically reassuring for feasibility. Capacitive hyperthermia is not currently listed on the Medicare Benefits Schedule (MBS) as a funded treatment modality in Australia, and no TGA-registered indication exists for cHT devices as standard oncology adjuncts. The RACGP and Cancer Australia guidelines do not currently include cHT recommendations for cervical or head and neck cancers. A small number of Australian academic centres (e.g., Peter MacCallum Cancer Centre) have research interest in hyperthermia, but clinical implementation remains investigational. PBS-listed chemotherapy regimens and TGA-approved radiotherapy for cervical cancer (concurrent cisplatin-based chemoradiation) represent the current standard of care. This review does not provide sufficient evidence to support TGA submission or MBS listing at this time, but may inform future clinical trial design within Australian cooperative oncology groups. Adult patients with locoregionally advanced cervical cancer and head and neck cancer undergoing radiotherapy and/or chemotherapy represent the subgroups with the most consistent signal of benefit. Patients with NSCLC do not appear to benefit based on current Phase III evidence. Applicability to other tumour types requires further investigation.

Abstract

INTRODUCTION: Capacitive hyperthermia (cHT) has been established for superficial tumors but the efficacy of cHT for intermediate or deep-seated tumors remains a subject of debate. This review is an evaluation of the current clinical evidence on the effectiveness of cHT in the treatment of tumors that are located deeper within the body. METHODS: A systematic review was conducted in accordance with the PRISMA guidelines of Phase III randomized controlled trials that included cancer patients of all ages and sexes with confirmed malignant tumors undergoing radiotherapy (RT) and/or chemotherapy (CT), with or without additional cHT. The literature search was conducted in PubMed and the Cochrane Register of Controlled Trials (CENTRAL). The primary endpoints included overall survival (OS), tumor response (TR; encompassing complete response (CR)), local control (LC), and cHT treatment-related toxicity (TRT). RESULTS: A total of nine randomized phase III trials were included in the study. The combination of cHT with RT and/or CT was found to improve both LC and OS in three out of five trials conducted in patients with cervical cancer. The analysis of both head and neck cancer trials demonstrated a marked increase in TR rates in cases where cHT was employed. Conversely, no such benefit was observed in non-small cell lung cancers and in a large multicenter cervical cancer trial. The treatment was well tolerated, with mild to moderate adverse events being the most common. CONCLUSION: It has been demonstrated that the combination of cHT with either RT or CT may improve TR and LC and, in certain cases, OS when compared with RT with or without CT alone. The occurrence of significant side effects is rare.

References

1. 1.Krahl, P., Kuroda, K., Contreras, J., Crezee, H., Gaipl, U. S., Kok, H. P., Minnaar, C., Navarro, F., Zips, D., Ghadjar, P., & Ohguri, T. (2026). The role of capacitive hyperthermia as an adjunct treatment in oncology: a systematic review of randomized phase III trials. International Journal of Hyperthermia, 43(1). https://doi.org/10.1080/02656736.2026.2678876