Pleural mesothelioma (PM) is a rare but aggressive thoracic tumor with a poor prognosis. Multimodal treatment—including induction chemotherapy, aggressive surgical resection, radiotherapy and immunotherapy in selected cases—currently represents the best therapeutic option. Single-center studies advocate hyperthermic intrathoracic chemotherapy (HITHOC) during surgical resection as an additional therapeutic option, although its impact on post-operative morbidity and survival has not yet been evaluated on a larger scale. HITHOC can be applied not only in the case of mesothelioma, but also in the case of thymoma with pleural involvement or—in very selected cases—in patients with secondary pleural metastases. Despite favorable outcomes and reduced clinical risks, there is no uniform approach to HITHOC, and a wide variety of indications and technical applications are still reported. Based on available data, HITHOC seems to offer a clear benefit in regard to overall survival of all mesothelioma patients; however, multicenter randomized controlled trials are required to validate and standardize this approach. The aim of this review is to focus on the present role of HITHOC in thoracic tumors with pleural involvement as well as on future challenges, particularly in the light of possible combined therapy of thoracic tumors still presenting poor prognoses.
胸膜间皮瘤是一种罕见但具有侵袭性的胸部肿瘤，预后较差。目前，多模式治疗——包括诱导化疗、积极的手术切除、放疗以及在特定病例中应用免疫治疗——代表了最佳治疗方案。单中心研究主张在手术切除期间采用胸腔内热灌注化疗作为附加治疗选择，尽管其对术后并发症发生率和生存率的影响尚未在大规模范围内得到评估。胸腔内热灌注化疗不仅适用于间皮瘤病例，也可用于胸腺瘤伴胸膜受累的患者，或在极少数特定情况下用于继发性胸膜转移患者。尽管临床效果良好且风险较低，但目前胸腔内热灌注化疗尚无统一的操作标准，其适应症和技术应用仍存在广泛差异。根据现有数据，胸腔内热灌注化疗似乎对所有间皮瘤患者的总生存期具有明确益处；然而，仍需开展多中心随机对照试验来验证和标准化该疗法。本综述旨在探讨胸腔内热灌注化疗在胸膜受累胸部肿瘤中的当前作用及未来挑战，尤其针对预后仍然较差的胸部肿瘤可能采用的联合治疗方案进行展望。
The Role of Hyperthermic Intrathoracic Chemotherapy (HITHOC) in Thoracic Tumors
肿瘤(癌症)患者之家