Zhou Hua, Wu Wei, Tang Xiaoping, Zhou Jianying, Shen Yihong
Department of Respiration, The First Affiliated Hospital, Zhejiang University, Hangzhou Department of Radiology, Jilin Provincial Tumor Hospital, Changchun, China.
Medicine (Baltimore). 2017 Jan;96(1):e5532. doi: 10.1097/MD.0000000000005532.
Although hyperthermic intraperitoneal chemotherapy (HIPEC) has been widely used to treat malignant ascites or as a preventive strategy for microscopic carcinomatosis following surgical resection of abdominal tumors, application of hyperthermic intrathoracic chemotherapy (HITHOC) in the treatment of malignant pleural effusion is limited. The objective of the current study was to conduct a systematic review and meta-analysis on the application of HITHOC in the palliative treatment of malignant pleural effusion.
After thorough searching of online databases, total 27 articles were included into qualitative systematic review and 5 of them were used to conduct qualitative meta-analysis.
It was found that most of HITHOC was used in combination of cytoreductive surgery (CRS) including pleurectomy/decortication or after surgical resection of primary tumors, which mainly were lung cancer, thymoma or thymic carcinoma, breast cancer, and ovarian cancer. Patients who received HITHOC had significantly longer median survival length compared to the patients without HITHOC (Hedges g = 0.763, P < 0.001). In addition, HITHOC therapy was favored (Hedges g = 0.848, P < 0.001) in terms of median survival length, tumor-free survival rate, with tumor survival rate or Karnofsky performance status (KPS) scale.
HITHOC is a safe and effective therapy in controlling pleural effusion and increasing patient's survival rate.
尽管热灌注腹腔化疗（HIPEC）已广泛用于治疗恶性腹水或作为腹部肿瘤手术切除后微小癌灶的预防策略，但热灌注胸腔化疗（HITHOC）在恶性胸腔积液治疗中的应用有限。本研究的目的是对HITHOC在恶性胸腔积液姑息治疗中的应用进行系统评价和荟萃分析。
在对在线数据库进行全面检索后，共纳入27篇文章进行定性系统评价，其中5篇用于进行定性荟萃分析。
发现大多数HITHOC与减瘤手术（CRS）联合使用，包括胸膜切除术/剥脱术或在原发性肿瘤手术切除后使用，原发性肿瘤主要为肺癌、胸腺瘤或胸腺癌、乳腺癌和卵巢癌。与未接受HITHOC的患者相比，接受HITHOC的患者中位生存长度显著更长（Hedges g = 0.763，P < 0.001）。此外，在中位生存长度、无瘤生存率、带瘤生存率或卡诺夫斯基功能状态（KPS）量表方面，HITHOC治疗更具优势（Hedges g = 0.848，P < 0.001）。
HITHOC是一种控制胸腔积液和提高患者生存率的安全有效的治疗方法。
