This ambispective observational cohort study will evaluate biological changes, palliative outcomes, and safety associated with ET-SPACE whole-body infrared hyperthermia in patients with advanced solid tumors. This noninvasive treatment uses infrared energy to raise body temperature in a controlled manner. Patients who received the treatment between January 1, 2022, and December 31, 2028, will be included. Earlier cases will be assessed retrospectively using medical records, while subsequently enrolled patients will be followed prospectively. Hyperthermia and all anticancer or supportive treatments will be provided according to routine clinical practice and will not be assigned by the study. The study will collect patient and tumor characteristics, laboratory findings, anticancer and supportive treatments, hyperthermia parameters, adverse events, and follow-up outcomes. It will assess changes in metabolism-related indicators, immune and inflammatory function, nutritional status, quality of life, cancer-related pain, functional status, symptom burden, and tumor-specific palliative scores. The study will also explore factors associated with more favorable outcomes and clarify the potential supportive and palliative role of whole-body infrared hyperthermia in patients with advanced solid tumors.
Study Type
OBSERVATIONAL
Enrollment
500
Zhejiang Hospital, Department of Oncology, Hangzhou, China, 310030
Hangzhou, Zhejiang, China
RECRUITINGMean Change From Baseline in Prognostic Nutritional Index at Week 4
The Prognostic Nutritional Index will be calculated as serum albumin in grams per liter plus five multiplied by the absolute lymphocyte count in 10\^9 cells per liter. Higher values generally indicate better nutritional and immunological status.
Time frame: Baseline within 7 days before the first hyperthermia session and Week 4, plus or minus 7 days, after the first session.
Mean Change From Baseline in Cancer Pain Intensity at Week 4
Cancer-related pain will be assessed using an 11-point Numeric Rating Scale ranging from 0, indicating no pain, to 10, indicating the worst imaginable pain. The outcome will be calculated as the Week 4 score minus the baseline score.
Time frame: Baseline within 7 days before the first hyperthermia session and Week 4, plus or minus 7 days, after the first session.
Mean Change From Baseline in EORTC QLQ-C30 Global Health Status Score at Week 12
The EORTC QLQ-C30 global health status scale ranges from 0 to 100, with higher scores indicating better overall health and quality of life. This outcome evaluates the durability of quality-of-life changes.
Time frame: Baseline within 7 days before the first hyperthermia session and Week 12, plus or minus 14 days, after the first session.
Mean Change From Baseline in Edmonton Symptom Assessment System-Revised Total Score at Week 4
The Edmonton Symptom Assessment System-Revised evaluates nine common symptoms, including pain, fatigue, nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath. The total score ranges from 0 to 90, with higher scores indicating greater symptom burden.
Time frame: Baseline within 7 days before the first hyperthermia session and Week 4, plus or minus 7 days, after the first session.
Change From Baseline in Eastern Cooperative Oncology Group Performance Status at Week 4
Eastern Cooperative Oncology Group performance status ranges from 0 to 5, with higher grades indicating poorer functional status. Improvement is defined as a decrease of one or more grades, deterioration as an increase of one or more grades, and stability as no change.
Time frame: Baseline within 7 days before the first hyperthermia session and Week 4, plus or minus 7 days, after the first session.
Mean Change From Baseline in Systemic Immune-Inflammation Index
The Systemic Immune-Inflammation Index will be calculated as the peripheral platelet count multiplied by the neutrophil count and divided by the lymphocyte count. The outcome will evaluate acute and short-term changes in systemic immune-inflammatory status.
Time frame: Baseline within 7 days before the first hyperthermia session, 24 to 72 hours after the first session, and Week 4, plus or minus 7 days.
Mean Change From Baseline in Peripheral Blood CD4 to CD8 T-Cell Ratio
The ratio of CD4-positive T lymphocytes to CD8-positive T lymphocytes will be measured by flow cytometry when available. The outcome will evaluate changes in peripheral cellular immune status.
Time frame: Baseline within 7 days before the first hyperthermia session, 24 to 72 hours after the first session, and Week 4, plus or minus 7 days.
Change From Baseline in Patient-Generated Subjective Global Assessment Nutritional Category
Nutritional status will be classified using the Patient-Generated Subjective Global Assessment as Category A, well nourished; Category B, moderately or suspected of being malnourished; or Category C, severely malnourished. Changes between categories will be reported.
Time frame: Baseline within 7 days before the first hyperthermia session and Week 12, plus or minus 14 days, after the first session.
Mean Change From Baseline in Daily Oral Morphine Equivalent Dose at Week 4
Daily opioid consumption will be converted to oral morphine equivalent dose in milligrams per day using standardized conversion factors. The outcome will evaluate changes in analgesic requirements.
Time frame: Baseline within 7 days before the first hyperthermia session and Week 4, plus or minus 7 days, after the first session.
Number of Participants With Whole-Body Infrared Hyperthermia-Related Adverse Events
Adverse events considered possibly, probably, or definitely related to whole-body infrared hyperthermia will be recorded and graded according to the Common Terminology Criteria for Adverse Events version 5.0. The number and percentage of participants experiencing any adverse event and Grade 3 or higher adverse events will be reported.
Time frame: From the first hyperthermia session through 30 days after the final hyperthermia session, assessed for up to 16 weeks.
Response Rate According to Response Evaluation Criteria in Solid Tumors Version 1.1
Objective response rate is defined as the percentage of evaluable participants whose best overall response is complete response or partial response according to Response Evaluation Criteria in Solid Tumors version 1.1. Tumor response may reflect all concomitant anticancer treatments received during the observation period.
Time frame: From the first hyperthermia session through the first scheduled tumor assessment at Week 12, plus or minus 14 days.
Disease Control Rate According to Response Evaluation Criteria in Solid Tumors Version 1.1
Disease control rate is defined as the percentage of evaluable participants whose best overall response is complete response, partial response, or stable disease according to Response Evaluation Criteria in Solid Tumors version 1.1.
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Time frame: From the first hyperthermia session through the first scheduled tumor assessment at Week 12, plus or minus 14 days.
Progression-Free Survival
Progression-free survival is defined as the time from the first whole-body infrared hyperthermia session to the first documented disease progression according to Response Evaluation Criteria in Solid Tumors version 1.1 or death from any cause, whichever occurs first. Participants without an event will be censored at the date of their last evaluable disease assessment.
Time frame: From the first hyperthermia session until disease progression or death, assessed for up to 12 months.
Overall Survival
Overall survival is defined as the time from the first whole-body infrared hyperthermia session to death from any cause. Participants who remain alive will be censored at the date they were last known to be alive.
Time frame: From the first hyperthermia session until death from any cause, assessed for up to 12 months.