Hofmann H-S, Wiebe K
Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauss-Allee 11, Regensburg, Germany.
Chirurg. 2010 Jun;81(6):557-62. doi: 10.1007/s00104-010-1926-2.
Recently cytoreductive surgery of primary and secondary pleural tumors has been combined with hyperthermic intrathoracic chemotherapy perfusion (HITHOC) for better local tumor control. In comparison to simple instillation of chemotherapeutic agents into the pleural cavity, the combination of surgical resection of pleural tumors and simultaneous HITHOC seems to be a more effective treatment. Intra-operative perfusion allows an improved distribution of the drug in the pleural space and a higher local concentration of the chemotherapeutic agents in contrast to systemic chemotherapy. Additional advantages of HITHOC are a better response to chemotherapeutic agents and synergistic antineoplastic effects. A prerequisite for safe application of HITHOC is compliance with safety regulations. Due to the reduction in morbidity and mortality this new concept is a valuable alternative for selected patients who do not undergo radical resection (e.g. extrapleural pneumonectomy). HITHOC is an additional therapeutic option in the multimodal treatment of patients with primary or secondary tumors of the pleura.
最近，原发性和继发性胸膜肿瘤的减瘤手术已与胸腔内热化疗灌注（HITHOC）相结合，以更好地控制局部肿瘤。与单纯向胸腔内注入化疗药物相比，胸膜肿瘤手术切除与同步HITHOC相结合似乎是一种更有效的治疗方法。与全身化疗相比，术中灌注可使药物在胸膜腔内分布更均匀，化疗药物局部浓度更高。HITHOC的其他优点是对化疗药物反应更好和具有协同抗肿瘤作用。安全应用HITHOC的一个先决条件是遵守安全规定。由于发病率和死亡率的降低，这一新概念对于未接受根治性切除（如胸膜外全肺切除术）的特定患者来说是一种有价值的替代方案。HITHOC是胸膜原发性或继发性肿瘤患者多模式治疗中的一种额外治疗选择。
