Hyperthermia and hypoxia: new developments in anticancer chemotherapy.

It has been demonstrated in vitro and in vivo that hyperthermia can enhance the cytotoxicity of some chemotherapeutic agents. The in vivo studies have demonstrated that the thermal advantage is maximized at mild temperatures such as at 40.5--43 degrees C. Thermo-chemotherapy is widely applied in limb perfusion and intraperitoneal chemotherapy. Hypoxia in solid tumours leads to resistance to most anticancer drugs and appears to accelerate malignant progression and increase metastasis. The recent development of new drugs highly toxic to hypoxic cells may bring new strategies in anticancer treatments and move this condition from being a problem to a new tool in cancer control.