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[Treatment of a radiculopathia by whole-body hyperthermia].

INTRODUCTION
Cancer metastases can be the reason of neuropathic pain. It can be caused by infiltration and compression of nerves. Cytokines released by tumor cells and the affected nerve structures induce an inflammatory reaction that enhances the neuropathic pain.


CASE REPORT
We report the case of a 67-year-old female patient. She suffered from a persisting and acutely exacerbated radiculopathy (L5/S1 right) due to metastases of breast cancer (pT1bL0N1R1G2M1/osseous; ER 95%, PR 95%, Her2-new-score 3+) in the lumbar spine. Traditional treatments had failed to yield sufficient therapeutic effects.


METHODS
We performed 6 sessions of water-filtered infrared-A whole-body hyperthermia using a commercial system (Iratherm 1000; Von Ardenne Institute for Applied Medical Research, Dresden, Germany). The wave-length was 600-1300 nm, the aimed body core temperature was 38.5 degrees C. The intensity of pain was assessed by visual analog scale.


RESULTS
Pain intensity (VAS) decreased from 9 (initial) to 3 points after the first 3 treatment sessions. The patient was completely free of pain after 6 sessions. No side-effects were observed. At follow up after 3 and 24 weeks the patient was still free of pain.


CONCLUSION
Infrared-A whole-body hyperthermia might be an effective therapeutic procedure with rare side-effects for tumor-induced neuropathic pain. Its use should be investigated further in controlled clinical trials.