Danuzzo Federica, Sibilia Maria Chiara, Vaquer Sara, Cara Andrea, Cassina Enrico Mario, Libretti Lidia, Pirondini Emanuele, Raveglia Federico, Tuoro Antonio, Petrella Francesco
Department of Thoracic Surgery, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy.
Cancers (Basel). 2024 Jul 11;16(14):2513. doi: 10.3390/cancers16142513.
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（PM）是一种罕见但侵袭性强的胸部肿瘤，预后较差。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采用免疫治疗——目前是最佳治疗选择。单中心研究提倡在手术切除期间进行胸腔内热化疗（HITHOC）作为一种额外的治疗选择，尽管其对术后发病率和生存率的影响尚未在更大规模上进行评估。HITHOC不仅可应用于间皮瘤病例，还可应用于伴有胸膜受累的胸腺瘤病例，或者在非常特定的情况下应用于伴有继发性胸膜转移的患者。尽管有良好的结果且临床风险降低，但对于HITHOC尚无统一的方法，仍有各种各样的适应症和技术应用被报道。基于现有数据，HITHOC似乎在所有间皮瘤患者的总生存方面提供了明显益处；然而，需要多中心随机对照试验来验证和规范这种方法。本综述的目的是关注HITHOC在伴有胸膜受累的胸部肿瘤中的当前作用以及未来挑战，特别是鉴于仍具有较差预后的胸部肿瘤可能采用联合治疗的情况。
