Present Practice of Radiative Deep Hyperthermia in Combination with Radiotherapy in Switzerland

SIMPLE SUMMARY: Moderate hyperthermia is a potent radiosensitizer and its efficacy has been proven in randomized clinical trials for specific tumor entities. In spite of this, hyperthermia still lacks general acceptance in the oncological community and implementation of hyperthermia in clinical practice is still low. Reimbursement is one key factor regarding the availability of hyperthermia for deep-seated tumors, with high variability in reimbursement between countries. We report the current reimbursement status and related pattern of care for the use of deep hyperthermia in Switzerland over a time period of 4.5 years. This analysis will provide the basis for the national standardization of deep hyperthermia treatment schedules and quality assurance guidelines, as well as for the expansion of deep hyperthermia indications in the future. This comprehensive insight into deep hyperthermia reimbursement and practice in Switzerland might also be of interest for other national hyperthermia societies. ABSTRACT: Background: Moderate hyperthermia is a potent and evidence-based radiosensitizer. Several indications are reimbursed for the combination of deep hyperthermia with radiotherapy (dHT+RT). We evaluated the current practice of dHT+RT in Switzerland. Methods: All indications presented to the national hyperthermia tumor board for dHT between January 2017 and June 2021 were evaluated and treatment schedules were analyzed using descriptive statistics. Results: Of 183 patients presented at the hyperthermia tumor board, 71.6% were accepted and 54.1% (99/183) finally received dHT. The most commonly reimbursed dHT indications were “local recurrence and compression” (20%), rectal (14.7%) and bladder (13.7%) cancer, respectively. For 25.3% of patients, an individual request for insurance cover was necessary. 47.4% of patients were treated with curative intent; 36.8% were in-house patients and 63.2% were referred from other hospitals. Conclusions: Approximately two thirds of patients were referred for dHT+RT from external hospitals, indicating a general demand for dHT in Switzerland. The patterns of care were diverse with respect to treatment indication. To the best of our knowledge, this study shows for the first time the pattern of care in a national cohort treated with dHT+RT. This insight will serve as the basis for a national strategy to evaluate and expand the evidence for dHT.