Hyperthermia and chemotherapy (Synergo® system)
What is it?
Synergo® treatment consists of intravesical thermo-chemotherapy. Local hyperthermia (40°-44°) administered in combination with selected cytotoxic agents has documented a synergistic antitumor response in numerous experimental "in vitro" and "in vivo" contexts and in many clinical protocols concerning the treatment of solid human neoplasms.
When is this procedure indicated?
Recent "in vitro" studies have unequivocally confirmed a reduction in the survival fraction in different cell lines of transitional neoplasms experimentally induced after chemo-hyperthermia treatment. At the clinical level, for more than 10 years, prospective studies have attested the high ablative (destructive) power against non-muscle invasive Bladder Neoplasms (MNIBC) of the microwave chemo-hyperthermia treatment (HT+CT) administered through the dedicated Synergo® system. The same studies have also documented the safety and good subjective tolerability of the Synergo® approach.
How is it performed?
The system includes an endocavitary (inside the bladder) microwave (915 MHz) applicator, an endocavitary temperature-sensing device, and a closed-loop circulating device for infusion, recirculation, and cooling of chemotherapy solution. Physical parameters during treatment are monitored and recorded by central computerized unit. The treatment, although more invasive than simple bladder instillations, is carried out on an outpatient basis and usually provides a treatment per week for 4 weeks followed by a variable number of monthly "maintenance" treatments. The treatment lasts about one hour.
Contraindications
Most of the observed side effects and complications are well known and already associated with intravesical chemotherapy instillations (without hyperthermia). Observed side effects are transient and generally without long-term impact on bladder function.
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