A New Device for the Treatment of Pleural Malignancies: Intrapleural Chemohyperthermia Preliminary Report

Carry, Pierre-Yves; Brachet, A; Gilly, F. N.; Sayag, A; Petit, Philippe; Rochette, C.; Mulsant, P.; Guibert, Benoît; Braillon, G; Banssillon, V.

doi:10.1159/000227208

Cited by 23 publications

(18 citation statements)

References 6 publications

(10 reference statements)

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“…With these doses, the systemic drug concentrations never reached the systemic toxic level and were lower than during IPCH (Carry et al, 1993). This difference could be explained by the lower absorption capacity of the pleural membrane and by the enhanced local tissue concentrations after hyperthermic perfusion (Ratto et al, 1999).…”

Section: Discussionmentioning

confidence: 94%

“…From January 1990 to October 1995, ITCH was performed with MMC for mesothelioma and with CDDP for metastatic carcinoma. After the feasibility study (Carry et al, 1993), ITCH was performed with both for each type of tumour from November 1995 to August 2000. One patient underwent a second procedure.…”

Section: Patientsmentioning

confidence: 99%

“…Combining the local effect of intrapleural chemotherapy with hyperthermia may offer an additional benefit: the effect of heat on cytotoxicity, demonstrated in vitro at temperatures over 42.51C (Crile, 1963); the synergistic effect of heat and chemotherapy on certain drugs like mitomycin C (MMC) and cisplatin (CDDP) (Barlogie et al, 1980;Teicher et al, 1981). We had already reported a phase I study on the combination of surgery, intrathoracic intrapleural chemotherapy and intrapleural hyperthermia (ITCH) for diffusive malignant pleural effusions (Carry et al, 1993). The feasibility, the toxicity and the preliminary results of this combined management were also reported by other teams (Matsuzaki et al, 1995;Markman, 1997;Yellin et al, 2001).…”

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confidence: 92%

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Long-term results of intrathoracic chemohyperthermia (ITCH) for the treatment of pleural malignancies

et al. 2003

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There is no standard treatment for patients with pleural malignancies. The aim of this prospective study was to investigate the toxicity and long-term results of a multimodality treatment consisting of surgery and intrathoracic chemohyperthermia (ITCH) for the treatment of patients with pleural malignancies. From January 1990 to August 2000, 24 patients with mesothelioma (n ¼ 17), fibrosarcoma (n ¼ 3), pleural adenocarcinoma (n ¼ 3) and thymoma (n ¼ 1) were included. The mesothelioma stages were T1 or T2 in 10 cases, and T3 or T4 in seven cases. After cytoreductive surgery, ITCH was carried out for over 60 min, at inflow temperatures less than 451C, either with mitomycin C (n ¼ 7) or cisplatin (n ¼ 5) or both (n ¼ 12). One patient died from major thoracic air leaks after major decortication and pleurectomy. Seven patients had complications, one pleural clotting necessitating reoperation. After a median follow-up of 89 months, the overall 1-year and 5-year survival rates were 74 and 27%, respectively. For T1 and T2 mesothelioma patients, the median survival was 41.3 months, and for T3 and T4 tumours, it was 4.5 months (P ¼ 0.001). The fibrosarcoma patients are alive with no evidence of recurrence at 24, 43 and 54 months. In the conclusion, the combination of surgery with ITCH with mitomycin and/or cisplatin is relatively safe. This procedure may offer unexpected long-term survival in a selected group of patients (T1 and T2 mesothelioma patients and fibrosarcoma patients).

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Section: Discussionmentioning

confidence: 94%

Section: Patientsmentioning

confidence: 99%

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confidence: 92%

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Long-term results of intrathoracic chemohyperthermia (ITCH) for the treatment of pleural malignancies

et al. 2003

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“…Combining the local effect of intrapleural chemotherapy with hyperthermia may offer an additional benefit: The intrapleural administration of chemotherapy agents was evaluated recently in patients with mesothelioma in a Phase II controlled clinical study 1. Combined management, including intrapleural chemotherapy and hyperthermia using a roller pump, was studied recently by Carry et al,2 who treated patients after pleurectomy for mesothelioma (3 patients) or adenocarcinoma (2 patients), and by Matsuzaki et al,3 who treated 19 patients with either pleural spread from lung carcinoma (12 patients) or malignant pleural effusions (7 patients). The objective of this study was to evaluate the feasibility, toxicity, and preliminary results of a multimodality treatment consisting of surgery, intrapleural chemotherapy, and hyperthermia that was given simultaneously to patients with various pleural malignancies.…”

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confidence: 99%

Hyperthermic pleural perfusion with cisplatin

Yellin

Simansky

Paley

et al. 2001

Cancer

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BACKGROUND The preferred treatment for patients with pleural tumors or tumors with pleural extension has not been determined. Systemic and local modalities were studied, including intrapleural chemotherapy and hyperthermia, which mainly have been investigated separately. The objective of this study was to investigate the feasibility, toxicity and early results of a multimodality treatment consisting of surgery, chemotherapy, and hyperthermia in one session for the treatment of patients with pleural malignancies. METHODS From November 1994 to September 1998, 26 patients (7 patients with mesothelioma, 11 patients with thymic neoplasms, and 8 patients with other tumors) underwent intraoperative hyperthermic pleural perfusion (HPP). Perfusion was performed with a roller pump and a heat exchanger. Cisplatin was added when the temperature stabilized to a mean of 40.8 °C (range, 40.2–41.5 °C). Dosages of cisplatin used were 60 mg in 2 patients, 100 mg in 2 patients, 120 mg in 1 patient, 150 mg in 18 patients, and 200 mg in 3 patients. The patients underwent the following associated surgeries: extended extrapleural pneumonectomy in 8 patients, resection of tumor without pleurectomy in 4 patients, resection of tumors with pleurectomy in 10 patients, and exploration and HPP only in 4 patients (thoracotomy in 2 patients and video‐assisted thoracoscopy in 2 patients). RESULTS There were no technical problems during the perfusion period. The systemic temperature rose to a maximum of 38 °C. There was no renal or hematologic toxicity, except in one patient who experienced thrombocytopenia. One patient died from complications related to a technical error. Eight patients had complications; the most bothersome were in four patients with empyema (early in two patients and late in two patients). The median postoperative hospital stay was 7 days (range, 2–50 days). Ten patients were alive 28–69 months after surgery. The overall 1‐year, 2‐year, and 3‐year survival rates were 72%, 65%, and 44%, respectively. Complete ipsilateral pleuropulmonary control was achieved in 17 patients (9 patients who are alive and 8 patients who have died). CONCLUSIONS Intraoperative HPP with cisplatin is feasible, easy to perform, and relatively safe. This method may offer excellent local control for patients with pleural tumors. Cancer 2001;92:2197–203. © 2001 American Cancer Society.

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“…The hyperthermia itself has a toxic effect on malignant cells [12] and modifies the toxicity of the chemotherapeutic agent [13]. However, systemic concentrations remain below toxic levels due to the limited absorption of the drug from the cavity.…”

Section: Discussionmentioning

confidence: 99%

Does cytoreduction surgery and hyperthermic intrathoracic chemotherapy prolong survival in patients with N0–N1 nonsmall cell lung cancer and malignant pleural effusion?

Nardini

2019

Eur Respir Rev

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IntroductionDebulking surgery and hyperthermic intrathoracic chemotherapy (HITHOC) has been successfully used in the treatment of thoracic tumours. Few authors report on the feasibility of its use in patients with lung cancer and malignant pleural effusion. The aim of this study was to evaluate the efficacy and results of debulking surgery and HITHOC in the treatment of selected patients with nonsmall cell lung cancer (NSCLC) and malignant pleural effusion.MethodsA systematic review was conducted in MEDLINE in accordance with PRISMA guidelines. The word search included: “hyperthermic intrathoracic chemotherapy and/or HITHOC or hyperthermic intrapleural”. Inclusion criteria were only those studies reporting a sufficient amount of data on HITHOC and surgery for lung cancer. Single case reports and review articles were excluded.Results20 articles were selected as they related to the topic of HITHOC and lung cancer. Most were from China (n=8) and Japan (n=6). Only four out of the 20 articles had sufficient data for this review. In total, data for 21 patients were collected. Debulking surgery ranged from wedge resection to pneumonectomy and pleurectomy. Mean survival was 27 months and median survival was 18 months (range 1–74 months). 13 patients out of 21 (62%) were alive at 1 year and six (28.5%) were alive at 2 years. 10 patients were still alive at the time of the respective publication in the 21 patients included. Systemic toxicity and treatment-related mortality were nil. There were insufficient data to perform a meta-analysis.ConclusionAlthough reported survival in this systematic review is encouraging, available evidence concerning debulking surgery and HITHOC in N0–N1 NSCLC with malignant pleural effusion is weak. Better evidence in the form of a randomised controlled trial is mandatory.

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A New Device for the Treatment of Pleural Malignancies: Intrapleural Chemohyperthermia Preliminary Report

Cited by 23 publications

References 6 publications

Long-term results of intrathoracic chemohyperthermia (ITCH) for the treatment of pleural malignancies

Long-term results of intrathoracic chemohyperthermia (ITCH) for the treatment of pleural malignancies

Hyperthermic pleural perfusion with cisplatin

Does cytoreduction surgery and hyperthermic intrathoracic chemotherapy prolong survival in patients with N0–N1 nonsmall cell lung cancer and malignant pleural effusion?

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