Local or Whole Body Hyperthermia Therapy for Treatment of Cancer
DESCRIPTION
Hyperthermia can be administered using local and whole body techniques. Local hyperthermia entails elevating the temperature of superficial or subcutaneous tumors while sparing surrounding normal tissue, using either external or interstitial modalities. Whole body hyperthermia requires the individual to be placed under either general anesthesia or deep sedation. The individual's body temperature is increased to 108° F by packing the individual in heated (hot water) blankets. The elevated body temperature is maintained for a period of 4 hours, while the essential body functions are closely monitored. Approximately 1 hour is required for a "cooling off" period, after which the individual is constantly observed for a minimum of 12 hours. This modality has been variously termed "systemic thermotherapy" or "whole body hyperthermia".
POLICY
Local hyperthermia therapy used in combination with radiation therapy for the treatment of primary or metastatic cutaneous or subcutaneous superficial malignancies is considered medically necessary if the medical appropriateness criteria are met. (See Medical Appropriateness below.)
Local hyperthermia therapy used alone or in combination with chemotherapy is considered investigational.
Local hyperthermia therapy for the treatment of brain tumors is considered investigational.
Whole body hyperthermia therapy for the treatment of all malignancies is considered investigational.
MEDICAL APPROPRIATENESS
Local hyperthermia therapy for the treatment of primary or metastatic cutaneous or subcutaneous superficial malignancies is considered medically appropriate if ANY ONE of the following criteria are met:
Individuals have failed previous therapy
Individuals are not candidates for conventional treatment
IMPORTANT REMINDER
We develop Medical Policies to provide guidance to Members and Providers. This Medical Policy relates only to the services or supplies described in it. The existence of a Medical Policy is not an authorization, certification, explanation of benefits or a contract for the service (or supply) that is referenced in the Medical Policy. For a determination of the benefits that a Member is entitled to receive under his or her health plan, the Member's health plan must be reviewed. If there is a conflict between the Medical Policy and a health plan, the express terms of the health plan will govern.
ADDITIONAL INFORMATION
Clinical data supporting the use of local hyperthermia alone or in combination with chemotherapy and for the treatment of brain tumors is lacking.
There is insufficient evidence to support whole body hyperthermia therapy for the treatment of malignancies.
SOURCES
American Cancer Society. (2008, April). Hyperthermia. Retrieved February 26, 2009 from http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/hyperthermia.
BlueCross BlueShield Association. Medical Policy Reference Manual. (1:2003). Local or whole body hyperthermia (2.01.05). Retrieved November 10, 2011 from BlueWeb. (9 articles and/or guidelines reviewed)
Complete Guide to Medicare Coverage Issues [Computer software]. (2011, November). Hyperthermia for treatment of cancer (NCD 110.1, p. 2-52). Ingenix.
Krawczyk, P. M., Eppink, B., Essers, J., Stap, J., Rodermond, H., Odijk, H., et al. (2011). Mild hyperthermia inhibits homologous recombination, induces BRCA2 degradation, and sensitizes cancer cells to poly (ADP-ribose) polymerase-1 inhibition. Proceedings of the National Academy of Sciences of the United States of America, 108 (24), 9851-9856.
National Cancer Institute. (2011, August). Hyperthermia in cancer treatment. Retrieved November 10, 2011 from http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/hyperthermia.
Raoof, M., & Curley, S. A. (2011). Non-invasive radiofrequency-induced targeted hyperthermia for the treatment of hepatocellular carcinoma. International Journal of Hepatology, 676957, 1-6.
Silva, A. C., Oliverira, T. R., Mamani, J. B., Malheiros, S. M., Malavolta, L., Pavon, L. F., et al. (2011). Application of hyperthermia induced by superparamagnetic iron oxide nanoparticles in glioma treatment. International Journal of Nanomedicine, 6, 591-603.
U. S. Food and Drug Administration. (2010, March). Center for Devices and Radiological Health. 510(k) Premarket Notification Database. K092366. Retrieved November 10, 2011 from http://www.accessdata.fda.gov/cdrh_docs/pdf9/K092366.pdf.
Zagar, T. M., Oleson, J. R., Vujaskovic, Z., Dewhirst, M. W., Craciunescu, O. I., Blackwell, K. L., et al. Hyperthermia combined with radiation therapy for superficial breast cancer and chest wall recurrence: A review of the randomised data. International Journal of Hyperthermia, 26 (7), 612-614.
ORIGINAL EFFECTIVE DATE: 4/1981
MOST RECENT REVIEW DATE: 12/8/2011
ID_BT
Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.
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