Purpose: Tumor response and treatment toxicity are related to minimum and maximum tissue temperatures during hyperthermia, respectively. Using a large set of clinical data, we analyzed the number... Show morePurpose: Tumor response and treatment toxicity are related to minimum and maximum tissue temperatures during hyperthermia, respectively. Using a large set of clinical data, we analyzed the number of sensors required to adequately monitor skin temperature during superficial hyperthermia treatment of breast cancer patients.Methods: Hyperthermia treatments monitored with >60 stationary temperature sensors were selected from a database of patients with recurrent breast cancer treated with re-irradiation (23x2Gy) and hyperthermia using single 434MHz applicators (effective field size 351-396cm(2)). Reduced temperature monitoring schemes involved randomly selected subsets of stationary skin sensors, and another subset simulating continuous thermal mapping of the skin. Temperature differences (T) between subsets and complete sets of sensors were evaluated in terms of overall minimum (T-min) and maximum (T-max) temperature, as well as T90 and T10.Results: Eighty patients were included yielding a total of 400 hyperthermia sessions. Median T was<0.01 degrees C for T90, its 95% confidence interval (95%CI) decreased to 0.5 degrees C when>50 sensors were used. Subsets of<10 sensors result in underestimation of T-max up to -2.1 degrees C (T 95%CI), which decreased to -0.5 degrees C when>50 sensors were used. Thermal profiles (8-21 probes) yielded a median T<0.01 degrees C for T90 and T-max, with a 95%CI of -0.2 degrees C and 0.4 degrees C, respectively. The detection rate of T(max)43 degrees C is85% while using>50 stationary sensors or thermal profiles.Conclusions: Adequate coverage of the skin temperature distribution during superficial hyperthermia treatment requires the use of>50 stationary sensors per 400cm(2) applicator. Thermal mapping is a valid alternative. Show less