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Dear <<Title>> <<Last name>>,

As the year slowly draws to a close, now seems a good time to review the current status of hyperthermia before we enter the next decade. This is why we talked to an influential expert in the field, Professor Stephan Bodis, head of the Radiation Oncology Centers at the Canton Hospitals Aarau and Baden.

From his Swiss perspective and with 16 years of experience with hyperthermia, Prof. Bodis answered Monica Sennewald’s questions on the major achievements and challenges – both in the past and for the next generation. He discusses acceptance, and thus reimbursement, for hyperthermia while also providing a deep insight into his commitment within the field of hyperthermia on a personal, clinical and political level. 

You can read the full interview below.

With our very best wishes for the holiday season as well as health, success and happiness in 2020.

Dr. Sennewald Medizintechnik


1. Please could you briefly describe your professional self? 

Prof. Stephan Bodis: We know each other very well so let me add a little bit of humor. You could just go to Wikipedia and look up my name and whatever is written there. This is quite a concise summary and in one sentence: I love the job because I love to take care of patients and human beings in general. 
Monica Sennewald: Ok, let’s quote Wikipedia.

Wikipedia on Stephan Bodis
Stephan Bodis (*February 16, 1958 in Basel) is a Swiss radiation oncologist. He is head of the Radiation Oncology Center Canton Hospitals Aarau and Baden. Stephan Bodis started studying medicine at Freiburg University in Switzerland in 1978 and completed his studies at the University of Basel in 1984. He then worked in the Department of Medical Oncology at Canton Hospital Baden until 1987 and at University Hospital Zurich until 1989. He was a fellow of the European Society for Medical Oncology (ESMO) from 1989 until 1991, and also a research fellow at the Department of Hematology/Oncology and Molecular Pharmacology at the Institut Gustave Roussy in Villejuif near Paris. This was followed by a clinical and research residency and fellowship in the Radiation Oncology Department at the Joint Center for Radiotherapy at the Harvard Medical School... 
>Read more
2. How was the development of hyperthermia in the last 16 years under your lead, what were the biggest achievements and the challenges?
Prof. Stephan Bodis: Firstly, I had almost no idea about hyperthermia when I started here in 2003. However, we had an excellent service provided by you and we decided after two very challenging years − when we had to rebuild the whole department including the replacement of all LINACs – to relaunch the hyperthermia program. 
Secondly, positively surprised that with the knowledge still present in the department and additional expertise acquired through training and instruction from both academic institutions and from industry, we were able to relaunch a high-quality clinical service required for our patient treatment and required from our referring physicians. 
After replacing sequentially, the superficial and then the deep hyperthermia system, we needed to establish structured tumor boards. In 2015 health insurance companies wanted to challenge our hyperthermia reimbursement and offered reimbursement restricted to only one indication of combined superficial hyperthermia and radiotherapy. We decided to challenge this offer and submitted a 500-page request to the Swiss Ministry of Health for mandatory reimbursement for out-patient therapy of nine indications for combined superficial and deep hyperthermia, always jointly with fractionated state-of-the-art radiotherapy. In Switzerland we have a standard submission procedure for these requests. Such requests need to focus on economy, efficacy, safety and scientific evidence of this medical procedure. With the positive decision by the Ministry of Health, which is not so easy to get upon request of a single institution, we relaunched hyperthermia in a structured way with a Swiss Hyperthermia Network, with weekly national hyperthermia tumor boards as required by the Swiss Ministry of Health and with our own clinical trials.  
From 2020 on we have new challenges: We have to get final approval from the Swiss Ministry of Health now for seven deep hyperthermia indications granted for a four-year time period. All four indications for superficial hyperthermia were granted indefinitely. We have to find consensus among the different hyperthermia providers about how we select patients for therapy, how we try to improve patient enrollment in clinical protocols and how we push and prioritize innovative research within our Swiss Hyperthermia Research Network.
3. Could you please summarize the situation of hyperthermia in Switzerland?
Prof. Stephan Bodis: In January 2016 we received a letter from the Ministry of Health based on a critical input from one of the major health insurance providers about the lack of evidence and therefore the potential stop for reimbursement of oncologic hyperthermia indications. Hyperthermia (always combined with radiotherapy) was reimbursed previously by a case-by-case decision. So, there was no federal decision for (mandatory) reimbursement in Switzerland based on evidence for the efficacy of oncologic thermotherapy in combination with radiotherapy. Because it was a low volume of patients and therefore also a (relatively) low reimbursement volume there was no systematic evaluation of economy, efficacy, safety and scientific evidence of this treatment combination for selected indications. This was then launched by our institution alone in 2016.

Our request submitted to the Federal Ministry of Health had a volume of several hundred pages. We had many fruitful discussions with national authorities and international experts. We also had great help from Prof. Niloy Datta who carefully compiled all available international study data and we also benefitted from our recently published series of meta-analysis (Datta et al.) which provided evidence for a long-term benefit of combined hyperthermia and radiotherapy vs. radiotherapy alone. >> Read on
4. I would like to hear more about your personal motivation as head of your department to engage in the field of hyperthermia
Prof. Stephan Bodis: For big questions very often the answer is a very easy one. It’s all about patients. In 2004 (and of course still in 2019) we had patients referred to our department where radiotherapy alone (or radiotherapy combined with any form of systemic therapy) was far from optimal. But I was skeptical about the added benefit of loco-regional moderate temperature hyperthermia to state-of-the-art radiotherapy for these patients. 
Monica Sennewald: Yes, I remember talking to you in your clinic in Aarau and you were saying that you were very skeptical about hyperthermia in the beginning. 

Prof. Stephan Bodis: I had the chance to be trained in various excellent academic institutions in Europe and in the States and hyperthermia was not provided by these institutions. Also, we had and we still have a lack of mature data from multicentric, randomized phase III clinical trials with long term follow up documenting a survival benefit without added significant toxicity for oncologic hyperthermia in combination with radiotherapy and/or chemotherapy. We should have started international randomized phase III clinical trials in a structured way 20-30 years ago.
5. What would you see as most relevant when it comes to establishing hyperthermia as a standard treatment?
6. Aarau is well-known for having done the meta-analyses by Prof. Niloy Datta under your lead. This had never been done before in the field of hyperthermia. 
>> Click here to view the interview in its entirety


Campus Biomedico, nuovo strumento per combattere i tumori col calore
New Hyperthermia Unit for Rome

With the installation of two new Linacs and two new hyperthermia treatment systems, the University Hospital Campus Bio-Medico Rome recently opened its new thermal oncology unit. The clinic chose the Pyrexar BSD-500 superficial/interstitial system and a BSD-2000 deep regional hyperthermia system to improve cancer treatment. 

On the occasion of an extensive interview with the Italian newspaper CORRIERE DELLA SERA, the University Hospital Campus Bio-Medico explained it is investing in hyperthermia due to enhanced efficacy, inhibition of DNA repair and anti-tumor immune response, among other reasons. >> Click here to see the original article online




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