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In infectious diseases, natural fever stimulates a most effective immune response.

Using medical hyperthermia devices, controlled heating of targeted areas or even the whole body shows considerable potential in the treatment of various chronic and malignant diseases.

In oncology, hyperthermia can act as a potent sensitizer for radio-, chemo-, and immunotherapy by (re-)oxygenation, inhibition of DNA repair, and stimulation of antitumor immune response.

Water-filtered infrared A (wIRA) is the most effective way of contact-free thermal energy input into human tissue.

Using sealed water cuvettes, wIRA mimics the sun’s thermal irradiation in a humid, life-friendly atmosphere. Water molecules filter out the wavelengths which would be absorbed in the outermost layers of the skin. Thus, a higher energy input and penetration depth can be achieved.

Since 1995, heckel is one of the leading proponents in the field of hyperthermia.

In 2005 heckel began a strategic partnership with the company Hydrosun Medizintechnik GmbH, known for their experience in the research and manufacture of water-filtered infrared-A (wIRA) radiators.

Together, the two companies developed the infrared whole-body hyperthermia system heckel-HT3000 and the thermography-controlled wIRA superficial hyperthermia device hydrosun®TWH1500.

Both systems are manufactured by Hydrosun and marketed worldwide exclusively by heckel.

Local recurrence of breast cancer is frequently a therapeutic challenge.

In case of irresectability and pre-irradiation, effective tumor control by re-irradiation faces the risk of cumulative radiotoxicity. These heavily pretreated patients are often also resistant to systemic therapies, or the side-effects of these therapies must be weighed against the limited anti-tumor effects that can be expected.

Overall response rate in 201 patients treated with combined superficial hyperthermia and hypofractionated re-RT schedule of 5 x 4 Gy (TD 20 Gy) was 95% (see the detailed response and control rates for different size classes in Notter et al 2020).

In case of resectability, R1 resection (“microscopic disease”) or low margins cause a high risk of local re-recurrence. The same schedule of combined HT/RT can be used as adjuvant re-RT.

The hydrosun®TWH1500, using water-filtered infrared A with a high and most compliant energy input to deeper tissue layers is the first oncological local hyperthermia device that enables a contact-free supply of energy.

This allows for continous real-time thermographic control with automatic switch on and off control functions making optimal and safe energy input possible, while achieving an effective heating depth of at least 15mm (>40°C) respectively 20mm (>39.5°C) if maximum skin temperature is set at 42- 43°C.

Thus, the incidence of thermal skin damage (TSD) ≥ grade 2 has been reduced to < 1 Promille. Additionally, the physiological reactions in the treatment area can be observed real-time and analyzed even after the session has ended.

The treatment is most agreeable for the patient. The patient does not suffer from any body fixation or painful applicator contact, e.g. with ulcerated lesions.

By using a twin-applicator system, the performance of the hydrosun®TWH1500 is unaffected by heterogenous body contours and it easily covers large treatment areas for effective hyperthermia of large-sized chest wall recurrence, especially in lymphangiosis carcinomatosa.

In order to achieve the most beneficial effects, the time gap between hyperthermia and radiotherapy treatment should be as short as possible.

Using thermography-controlled wIRA superificial hyperthermia, (re-)irradiation is performed few minutes after completion of a 45-60 min hyperthermia session.

This combination and timing enables effective tumor control with

• significantly reduced RT dosage and toxicity

• option of safe re-irradiation even in cases where re-irradiation in therapeutic dosage alone is not an option or associated with the risk of severe side-effects.

SWITZERLAND:

• Lindenhofspital Bern

• Kantonsspital Aarau

• Kantonsspital Winterthur

• Kantonsspital Luzern

• ZIO in der Radiotherapie Hirslanden Männedorf bei Zürich

GERMANY:

• University Medical Center Freiburg

• Radioonkologie und Strahlentherapie Bremen

• Radiologie München, Strahlentherapie im Klinikum Schwabing

• University Medical Center Magdeburg

AUSTRIA:

• Ordensklinikum Linz Barmherzige Schwestern

• Strahlenklinik der Medizinischen Universität Graz

NETHERLANDS:

• Amsterdam UMC

UK:

• Guy's Cancer Center / King's College London

PORTUGAL:

• Julio Teixeira in Instituto CUF Porto

The healthy organism reacts to the threat of illness with regulated increase in temperature. In cases of acute infections, high fever triggers an enhanced immune response. Body temperature plays a crucial role in the most complex regulation of the immune system. Fever can be considered as being a temporary "special immune program" of nature.

Whole-body hyperthermia can mimic some of these effects and help to "reset" the immune system to overcome chronic pathologic dysfunctions in case of chronic inflammation and auto-immune diseases as well as support anti-tumor immune surveillance.

Beside immune effects, whole-body hyperthermia has strong perfusional effects and is effective in relaxing deep-seated muscle layers, reducing chronic pain disorders.

• Fibromyalgia

• Depression

• Chronic infection and post-infectious chronic disorders

• Module of Integrative Oncology

• Heat input with skin-compatible and depth-effective water-filtered IR-A-radiation (wIRA) directly into the blood-streamed tissue.

• Quick and tolerable increase in body core temperature. Good compliance, even with several hours of application.

• Great lying comfort on an adjustable patient's bed.

• Immediate transition into the heat retention phase (over several hours as required) where the position of the patient can be changed gradually between the lying and seated positions.

• Special documentation software FebroData with manifold options.