Journal of Microwave Power
and Electromagnetic Energy (JMPEE) |
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TITLE |
Clinical Hyperthermia
Trials: Design Principles and Practice [PDF] |
AUTHORS |
M. Salcman 1981 16 2 171-178 |
YEAR |
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Abstract The initial development
of a significant risk device is predicated upon demonstrable medical need and
an adequate biophysical rationale. Although microwave and radiofrequency
thermotherapy systems strongly meet these requirements, their clinical
evaluation has often suffered from inadequate or inappropriate preclinical
laboratory experimentation. It is suggested that devices be tested in animals
rather than phantoms and that thermal profiles, cooling curves, power vs.
temperature studies et at be carried out in the organ or organs of interest.
Clinical trials can then be designed in which an attempt is made to replicate
laboratory measurements in humans in order to develop physical dose-response
relationships and toxicity data (i.e. a phase-I or feasibility study). The
experimental paradigm for clinical drug testing can also be applied, with
some modifications, to the further evaluation of devices for the
determination of therapeutic response rates (phase-11) and controlled
evaluation against available treatments in a homogeneous patient population
(phase-III). It is extremely important that early clinical trials not be
contaminated by the possible effects of other concurrent therapies and that
sophisticated statistical design be employed to protect human subjects from
unnecessary exposure to experimental treatments. The ethical issues involved
are best dealt with by good scientific design. |