Medical Radiology and Radiation Safety. 2021. Vol. 66. № 6. P. 81–92

Possibilities of Local Microwave Hyperthermia in Oncology

O.K. Kurpeshev

Siberian Scientific Research Institute of Hyperthermia, Novosibirsk, Russia.

Contact person: Orazakhmet Kerimbaevich Kurpeshev, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.


The review analyzes the features of the interaction of electromagnetic (EM) energy with various tissues and the temperature distribution in model, experimental and clinical studies from emitters for external and intracavitary microwave hyperthermia (MWHT). The effect of MWHT on the antitumor efficacy of radiation (RT) and / or chemotherapy (CT), as well as toxic effects on normal tissues, was studied. Based on the literature data and our own experience, some approaches to the treatment of cancer patients have been identified. The general principles of the method, the design features of the applicators and their role in creating a hyperthermic regime in tumors of superficial and subsurface localization are also considered. The development of methods for thermometric control and supply of the EM field, allowing relatively uniform heating of tumors, as well as the determination of the minimum effective thermal doses, remains a priority area of research both in MW and other hyperthermia methods.

Based on the literature data and our own experience, some approaches to the treatment of cancer patients have been identified.

Keywords: hyperthermia, microwave radiation, radiation therapy, chemotherapy, thermoradiotherapy,  thermochemoradiation therapy

For citation: Kurpeshev OK. Possibilities of Local Microwave Hyperthermia in Oncology. Medical Radiology and Radiation Safety. 2021;66(6):81–92.

DOI: 10.12737/1024-6177-2021-66-6-81-92


1. Yarmonenko SP, Wainson AA. Radiobiology of humans and animals. –M.: Publishing house “Higher School”. 2004. 549 pp. (In Russ.).

2. Kurpeshev OK, Tsyb AF, Mardynsky YuS, Berdov BA. Development mechanisms and ways to overcome tumor chemoresistance. Part 2. The role of the relationship of stroma and parenchyma in the effectiveness of chemotherapy. Russian Oncological J. 2003;1:50–2. (In Russ.). 

3. Chaffer CL, Brueckmann I, Scheel C, Kaestli AJ, Wiggins PA, Rodrigues LO,  Brooks M,  Reinhardt F,  Su Y,  Polyak K,  Arendt LM,  Kuperwasser C,  Bierie B,  Weinberg RA. Normal and Neoplastic Nonstem Cells Can Spontaneously Convert to a Stem-Like State. Proceedings of the National Academy of Sciences of the United States of America (PNAS). 2011;108(19):7950–5. DOI: 10.1073/pnas.1102454108.

4. Heddleston JM, Li Z, Lathia JD, Bao S, Hjelmeland AB, Rich JN. Hypoxia Inducible Factors in Cancer Stem Cells. Br. J. Cancer. 2010;102(5):789–95. DOI: 10.1038/sj.bjc.6605551.

5. Van der Heijden AG, Dewhirst MW. Effects of Hyperthermia in Neutralizing Mechanisms of Drug Resistance in Non-Muscleinvasive Bladder Cancer. Int. J. Hyperthermia. 2016;32(4):434–45.

6. Ohguri T. Current Status of Clinical Evidence for Electromagnetic Hyperthermia on Prospective Trials. Thermal Med. 2015;31(2):5–12.

7. Kurpeshev OK, van der Zee J. Analysis of the Results of Randomized Studies of Hyperthermia in Oncology. Medical Radiology and Radiation Safety. 2018;63(3):52–67. (In Russ.). DOI: 10.12737/article_5b179d60437d54.24079640.

8. Pankratov VA, Andreev VG, Rozhnov VA, Gulidov IA, Baryshev VV, Buyakova ME, Vdovina SN, Kurpeshev OK, Podlesnykh NI. Simultaneous use of Chemotherapy and Radiation Therapy in Self-Conservative and Combined Treatment of Patients with Locally Advanced Cancer of the Larynx and Laryngopharynx. Siberian J. Oncology. 2007;1:18–22. (In Russ.).

9. Kurpeshev OK. Patterns of the Radiosensitizing and Damaging Effects of Hyperthermia on Normal and Tumor Tissues. Author’s abstract. diss. PhD, MD. Obninsk, 1989. 35 pp. (In Russ.). 

10. Kurpeshev OK, Van der Zee J. The Experimental Basis for the Use of Hyperthermia in Oncology. Medical Radiology and Radiation Safety. 2018;63(1):57-77. (in Russ.). DOI: 10.12737/article_5a8556b4be3e24.36808227. 

11. Abe M, Hiraoka M, Takahashi MI, Egawa S, Matsuda C, Onoyama Y, Morita K, Kakehi M, Sugahara T. Multi-Institutional Studies on Hyperthermia Using an 8-MHz Radiofrequency Capacitive Heating Device (Thermotron RF-8) in Combination With Radiation for Cancer Therapy. Cancer 1986;58(8):1589–95. 

12. Kurpeshev OK, van der Zee J. Locoregional Hyperthermia of Malignant Tumors Methods, Thermometry, Equipment. Medical Radiology and Radiation Safety. 2017;62(5):53–63. (In Russ.). DOI 10.12737/article_59f30321207ef4.88932385.

13. Johnson CC, Guy AW. Nonionizing Electromagnetic Wave Effects in Biological Materials and Systems. Proceedings of IEEE. 1972;60(6):692–718.

14. Trefná H.D., Crezee H., Schmidt M, Marder D, Lamprecht U, Ehmann M, Nadobny J, Hartmann J, Lomax N, Abdel-Rahman S, Curto S, Bakker A, Hurwitz MD, Diederich CJ, Stauffer PR, Van Rhoon GC. Quality Assurance Guidelines for Superficial Hyperthermia Clinical Trials: I. Clinical requirements. Int J Hyperthermia, 2017.

15. Kok HP, De Greef M, Correia D, Vorde Sive Vording Zum, Van Stam PJ. Gelvich EA, Bel A, Crezee J. FDTD Simulations to Assess the Performance of CFMA-434 Applicators for Superficial Hyperthermia. Int J Hyperthermia. 2009;25: 462-476.

16. Kok HP, Cressman ENK., Ceelen W, Brace CL, Ivkov R, Grüll H. ter Haarj G, Wustk P, Crezeea J. Heating Technology for Malignant Tumors: a Review. Int J Hyperthermia. 2020;37(1): 711-741. doi:10.1080/02656736.2020.1779357.

17. Guirado FN, Martinez JC, Sanchez AF. Hipertermia Oncológica Profunda Conformada Provocada por Campos Electromagnéticos No Ionizantes. Conformed Deep Oncologic Hyperthermia Caused by Electromagnetic Fields. Rev. Fis. Med. 2018;19(1):11–44.

18. Kok HP, Correia D, de Greef M, Van Stam G, Bel A, Crezee J. SAR Deposition by Curved CFMA-434 Applicators for Superficial Hyperthermia: Measurements and Simulations. Int J Hyperthermia. 2010;26(2):171–84.

19. De Bruijne M, Wielheesen DHM., Van der Zee J, Chavannes N, Van Rhoon GC. Benefits of Superficial Hyperthermia Treatment Planning: Five Case Studies. Int J Hyperthermia. 2007;23(5):417–29.

20. Petrovich Z, Debicki P, Astrahan MA, Baert L. Clinical Practice of Intracavitary Thermoradiotherapy. Thermoradiotherapy and Thermochemotherapy Volume 2: Clinical Applications 1996. P. 263–74.

21. Roos DI, Seegenschmiedt MH, Sorbe B. Intracavitary Heating Technologies. In: Seegenschmiedt MH, Fessenden P, Vernon CC. (eds). Thermoradiotherapy and Thermochemotherapy. Medical Radiology (Diagnostic Imaging and Radiation Oncology). Springer, Berlin, Heidelberg. Springer-Verlag Berlin Heidelberg 1995. P. 321–29. 

22. Kok HP, van Haaren PMA, van de Kamer JB, Crezee J. Theoretical Comparison of Intraluminal Heating Techniques. Int J Hyperthermia. 2007;23(4):395–411. DOI: 10.1080/02656730701344520.

23. Silin AO. Features of the Spatial Distribution of Electromagnetic Fields of Medical Microwave Applicators. Processing Systems Information. 2015;136(11):163–6. (In Russ.).

24. Kurosaki H, Sakurai H, Mitsuhashi N, Tamaki Y, Akimoto T, Takahashi T, Furuta M, Saitoh J-I, Hayakawa K, Niibe H. Biological Cell Survival Mapping for Radiofrequency Intracavitary Hyperthermia Combined with Simultaneous High Dose-Rate Intracavitary Irradiation. Jpn. J. Cancer Res. 2001;92:95–102. 

25. Kang M, Liu WQ, Qin YT, Wei Z-X, Wang R-S. Long-Term Efficacy of Microwave Hyperthermia Combined with Chemoradiotherapy in Treatment of Nasopharyngeal Carcinoma with Cervical Lymph Node Metastasis. Asian Pac J Cancer Prev. 2013;14:7395–400.

26. Overgaard J, Gonzalez Gonzalez D, Hulshof MC, Arcangelis G, Dahl O, Mella O, Bentzen SM. Randomized Trial of Hyperthermia as Adjuvant to Radiotherapy for Recurrent or Metastatic Malignant Melanoma. Lancet. 1995;345(8949):540–3. 

27. Egawa S, Tsukiyama I, Watanabe S, Ohno Y, Morita K, Tominaga S, Onoyama Y, Hashimoto S, Yanagawa S, Uehara S, Abe M, Mochizuki S, Sugiyama A, Inore T. A Randomized Clinical Trial of Hyperthermia and Radiation Versus Radiation Alone for Superficially Located Cancers. J Jpn. Soc Ther Radiol Oncol. 1989;1:135–40.

28. Perez CA, Pajak T, Emami B, Tupchong L, Rubin P. Randomized Phase III Study Comparing Irradiation and Hyperthermia with Irradiation Alone in Superficial Measurable Tumors. Final Report by the Radiation Therapy Oncology Group. Am. J. Clin. Oncol. 1991;14(2):133–41. 

29. Valdagni R, Amichetti M. Report of Long-Term Follow-Up in a Randomized Trial Comparing Radiation Therapy and Radiation Therapy Plus Hyperthermia to Metastatic Lymphnodes in Stage IV Head and Neck Patients. Int J Rad Oncol Biol Phys. 1994;28:163–9.

30. International Collaborative Hyperthermia Group (Vernon CC, Hand JW, Field SB, Machin D, Whaley JB, van der Zee J, van Putten WL, van Rhoon GC, van Dijk JD, González González D, Liu FF, Goodman P, Sherar M. Hyperthermia in the Treatment of Superficial Localized Primary and Recurrent Breast Cancer – Results From Five Randomized Controlled Trials. Int J Rad Oncol Biol Phys. 1996;35:731–44. 

31. Vargas HI, Dooley WC, Fenn AJ, Tomaselli MB. Study of Preoperative Focused Microwave Phased Array Thermotherapy in Combination with Neoadjuvant Anthracycline-Based Chemotherapy for Large Breast Carcinomas. Cancer Therapy. 2007;5:401–8.

32. Trotter JM, Edis AJ, Blackwell JB, Lamb MH, Bayliss EJ, Shepherd JM, Cassidy B. Adjuvant VHF Therapy in Locally Recurrent and Primary Unresectable Rectal Cancer. Australias Radiol. 1996;40(3):298–305. 

33. Shchepotin IB, Evans SRT, Chorny V, Osinsky S, Buras RR, Maligonov P. Intensive Preoperative Radiotherapy with Local Hyperthermia for the Treatment of Gastric Carcinoma. Surg Oncol. 1994;3(1):37–44.

34. Maslennikova AV. Thermoradiation and Chemoradiotherapy of Localized Cancer of the Pharynx and Larynx. – Author’s Abstract. Diss. PhD Med. Nizhny Novgorod. 2008. 37 pр. (In Russ.).

35. Kouloulias V, Triantopoulou S, Vrouvas J. Gennatas K, Ouzounoglou N, Kouvaris J, Karaiskos P, Aggelakis P, Antypas C, Zygogianni A, Papavasiliou K, Platoni K, Kelekis N.  Combined Chemoradiotherapy with Local Microwave Hyperthermia for Treatment of T3N0 Laryngeal Carcinoma: A Retrospective Study with Long-Term Follow-Up. Acta Otorhinolaryngol Ital. 2014;34(3):167–73.

36. Andreev VG, Mardynsky YuS. Beam and Combined Treatment of Laryngeal Cancer. Moscow. 1998. 115 pp. (In Russ.).

37. Kurpeshev OK, Zubarev AL. The Results of Chemo- and Thermo-Radiation Therapy of Patients with Soft Tissue Sarcoma Who Underwent and Did Not Undergo Surgery. Oncology. 2006;8(3):255–9. (In Russ.).

38. Kurpeshev OK, Ragulin YuA., Mozerov SA, Orlova AV, Lebedeva TV. Possibilities of Local Hyperthermia in the Treatment of Patients with Edematous Form of Breast Cancer. Problems in Oncology. 2016;62(5):680–7. (In Russ.). 

39. Chen HW, Fan JJ, Luo W. A Randomized Trial of Hyperthermo-Radiochemotherapy for Uterine Cervix Cancer. Chinese J. Clin. Oncol. 1997;24:249–51.

40. Wang J, Li D, Chen NA. A Clinical Study on Intraluminal Hyperthermia Combined with External Irradiation for Esophageal Carcinoma. Chinese J Cancer Research. 1996;8(3):200–04.

41. You Q-S, Wang R-Z, Suen G-Q. Yan F-C, Gao Y-J, Cui S-R, Zhao J-H, Zhao T-Z, Ding L. Combination Preoperative Radiation and Endocavitary Hyperthermia for Rectal Cancer: Long-Term results of 44 Patients. Int J Hyperthermia. 1993;9(1):19–24. 

42. Qingshan Y, Shuhua Q, Min L, Rueizhi W. Clinical Results of Thermoradiotherapy of Patients with Carcinoma of Rectum. Jpn J Hyperthermic Oncol. 1996;12(3):251. (Abstracts. The First Congress of the Asian Society of Hypert. Oncol. (ASHO), 1996. AO-21). 

43. Hua Y, Ma S, Fu Z, Hu Q, Wang L, Piao Y. Intracavity Hyperthermia in Nasopharyngeal Cancer: A Phase III Clinical Study. Int J Hyperthermia. 2011;27(2):180–6. DOI:10.3109/02656736.2010.503982. 

44. Colombo R, Da Pozzo LF, Lev A, Freschi M, Gallus G, Rigatti P. Neoadjuvant Combined Microwave Induced Local Hyperthermia and Topical Chemotherapy Versus Chemotherapy Alone for Superficial Bladder Cancer. J Urol. 1996;155(4):1227–32.

45. Colombo R, Salonia A, Leib Z, Pavone-Macaluso M, Engelstein D. Long-Term Outcomes of a Randomized Controlled Trial Comparing Thermochemotherapy with Mitomycin-C Alone as Adjuvant Treatment for Non-Muscle-Invasive Bladder Cancer (NMIBC). BJU International. 2011;107(6):912–18.

46. Knysh V, Goldobenko GV, Kim FP, Kozhushkov AI, Barsukov YA, Tkachev SI, Ozhiganov EL. Thermoradiotherapy of Locally Advanced and Recurrent Colorectal Cancer. Jornal of N. N. Blokhin Russian Cancer Research Center RAMS. 1991;27(2):33–46. (In Russ.). 

47. Nevolskikh AА. The Effect of Local Hyperthermia on the Long-Term Results of the Combined Treatment of Locally Advanced Colorectal Cancer. Author’s Abstract. Diss. PhD Med. Obninsk.  2001. 118 p. (In Russ.).

48. Kurpeshev OK, Tsyb AF, Mardynsky YuS, Berdov BA, Kurpesheva AK. Local Hyperthermia in Radiation Therapy of Malignant Tumors (Experimental-Clinical Trial). Obninsk, 2007. 219 pp. (In Russ.).

49. Vlasov OА, Barsukov YA, Tkachev SI, Gordeev SS, Tsaryuk VF, Aliev VA. Reduction of the Stage of the Disease and Indices of Therapeutic Pathomorphosis in Various Variants of the Polyradiomodification Program in the Combined Treatment Regimens for Patients with Rectal Cancer. Oncological Coloproctology, 2018;8(2):63–72. (In Russ.). 

50. Barsukov YA, Knysh VI, Tkachev SI, Nikolaev AV, Oltarzhevskaya ND, Korovina MA, Perevoshchikov AG, Gradyushko AT, Shestopalova IM, Aliev VA, Kuzmichev DV, Mamedli ZZ, Glebovskaya VV. Results of the Combined Treatment of Colorectal Cancer under Conditions of Polyradiomodification. Bulletin of the Moscow Cancer Society. 2009;2:3–7. (In Russ.).

51. Malikhov AG. Modern Treatment Strategy for Patients with Operable Rectal Cancer. Author’s Abstract. Diss. PhD Med. Moscow. 2015. 42 pp. (In Russ.).

52. Ivanov SA, Petrov LO, Erygin DV, Gulidov IA, Karpov AA. Direct Effectiveness of Adding Local Hyperthermia to the Scheme of Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer. Research and Practical Medicine Journal. 2020;7(3):10–20. (In Russ.).

53. Li R-Y, Lin SY, Wang P. Long-Time Results of Cervix Cancer in Нyperthermia Combined with Radiotherapy. Jpn J Hyperthermic Oncol. 1996;12(3):257. (Abstracts. The First Congress of the Asian Society of Hypert. Oncol. (ASHO), 1996. AP-46). 

54. Li DJ, Chou CK, Luk KH, Wang JH, Xie CF, McDougall JA, Huang GZ. Design of Intracavitary Microwave Applicators for the Treatment of Uterine Cervix Carcinoma. Int J Hyperthermia. 1991;7(7):693–701.

55. Malikhov GG. Combined and Complex Treatment of Patients with Squamous Cancer of the Anal Canal. Author’s Abstract. Diss. PhD Med. Moscow. 2004. 23 pp. (In Russ.).

56. Kim DF. Combined Organ-Preserving Treatment of Patients with Squamous Cell Carcinoma of the Anal Canal. Author’s Abstract. Diss. PhD Med. Moscow. 2014. 24 pp. (In Russ.).

57. Kouloulias V,  Plataniotis G, Kouvaris J,  Dardoufas C,  Gennatas C,  Uzunoglu N, Papavasiliou C,  Vlahos L. Chemoradiotherapy Combined with Intracavitary Hyperthermia for Anal Cancer: Feasibility and Long-Term Results From a Phase II Randomized Trial. Am. J. Clin. Oncol. 2005;28(1):91–9.

58. Kozlov AA. The Role of Microwave Hyperthermia in the Palliative Treatment of Patients with Prostate Cancer and Recurrence of Bladder Cancer. Author’s Abstract. Diss. PhD Med. St. Petersburg. 2006. 24 pp. (In Russ.).

59. Karnaukh PA. Multiple Treatment of Patients With Prostate Cancer. Author’s Abstract. Diss. PhD Med. Moscow. 2007. 42 pp. (In Russ.).

60. Rasulov AO, Gordeev SS, Ivanov VA, Barsukov YA, Malikhov AG, Baichorov AB, Tkachev SI, Kozak E.N. A Short Course of Preoperative Radiation Therapy in Combination with Chemotherapy, Local Hyperthermia, and a Prolonged Interval Before Surgery in the Treatment of Rectal Cancer: Phase II study. Oncological Coloproctology. 2016;6(4):24–30. (In Russ.). DOI: 10.17650/2220 3478 2016 6 4 24 30. 

61. Van der Zee J, Van der Holt B, Rietveld PJM, Helle PA, Wijnmaalen AJ, Van Putten WLJ. Van Rhoon GC. Reirradiation Combined with Hyperthermia in Recurrent Breast Cancer Results in a Worthwhile Local Palliation. Br J Cancer. 1999;79(3/4), 483–490.

62. Liang S-B, Deng Y-M, Zhang N. Prognostic Significance of Maximum Primary Tumor Diameter in Nasopharyngeal Carcinoma. BMC Cancer 2013;13:260. DOI:10.1186/1471-2407-13-260.

63. Zlobec I, Minoo P, Karamitopoulou E. Rolecofi Tumor Size in the Preoperative Management of Rectal Cancer Patients. BMC Gastroenterology 2010;10:61–9.

64. Erygin DV, Berdov BA, Nevolskikh AA, Titova LN, Smirnova SG. Neoadjuvant chemoradiation therapy for locally advanced colorectal cancer. Oncology J. named P.A. Herzen. 2015;1:13-20. (In Russ.).

 PDF (RUS) Full-text article (in Russian)

Conflict of interest. The author declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. The article was prepared by one author.

Article received: 18.09.2021. 

Accepted for publication: 22.10.2021.