Current Status of Clinical Evidence for Electromagnetic Hyperthermia on Prospective Trials

Japanese Government approved the use of health insurance to cover the costs of electromagnetic hyperthermia in combination with radiotherapy in April 1990. In April 1996, electromagnetic hyperthermia was approved for clinical uses other than combination with radiotherapy. However,the established medical remuneration points of hyperthermia in health insurance were scarce, and tend to prohibit widespread use of electromagnetic hyperthermia due to the decreased profitability. Level I evidence based on meta-analysis and phase III study for electromagnetic hyperthermia in combination with radiotherapy was recognized in following various disease;head and neck cancer, breast cancer,malignant melanoma,non-small cell lung cancer,cervical cancer,rectal cancer and bladder cancer for local control rate and/or tumor response rate. Level I evidence for electromagnetic hyperthermia in combination with chemotherapy was also seen in patients with high-grade sarcoma and liver cancer. Improvements of the overall survival rate base on the level I evidence were confirmed in patients with cervical cancer, rectal cancer and high-grade sarcoma. In recent years, promising results for hyperthermia in combination with chemotherapy or chemoradiotherapy based on phase II study were reported. A brief overview of the clinical evidence and future perspective to revise the medical remuneration points for electromagnetic hyperthermia based on prospective trials including ongoing trials is provided in this article.