Intrapleural Hyperthermic Perfusion With Chemotherapy Increases Apoptosis in Malignant Pleuritis

Matsuzaki, Yasunori; Edagawa, Masao; Shimizu, Tetsuya; Hara, Masaki; Tomita, Masaki; Ayabe, Takanori; Onitsuka, Toshio

doi:10.1016/j.athoracsur.2004.05.025

Cited by 35 publications

(38 citation statements)

References 20 publications

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“…Following the perfusion, apoptosis among the tumor cells was 25.2% ± 4.6%, clearly a significant increase (p < 0.001). IPHC increases apoptosis in the malignant pleuritis [3]. Matsuzaki et al [4] studied the induction of apoptosis by IPHC for the MPM.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the next outcome of our IPHC treatments for lung cancers with pleural dissemination with effusion, which were performed from 1994 to 2004 (n = 11) [3], the median survival time of the IPHC group (n = 11) was 20 months. On the other hand, the median survival time of the control group (n = 11) was 6 months, thus there was a significant difference (p < 0.05) [3]. The ratio of spontaneous apoptosis of untreated tumor cells was 2.8% ± 2.0%.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Outcomes, Safety and Efficacy of Intrapleural Hyperthermic Chemotherapy for Thoracic Malignant Diseases with Pleural Effusion

Ayabe¹,

Tomita²,

Chosa³

et al. 2016

JCT

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Background: We have performed the cisplatin-based intrapleural hyperthermic chemotherapy (IPHC) for advanced lung cancer with pleural effusion and for malignant pleural mesothelioma (MPM). Retrospectively, the outcomes of the IPHC were evaluated. Methods: For 14 years from February, 2000 to February, 2014, we performed 14 cases of IPHC including 8 lung cancers (staged-IV) and 6 MPMs (staged-III: 5; IV: 1). We divided these cases in two groups; the lung cancer group (LC group) and MPM group, and assessed the perioperative factors, toxicities, and effectiveness. Results: The patient age averaged 66.5 ± 11.1 years old (11 males and 3 females). The pathology was 7 pulmonary adenocarcinomas, 1 pulmonary angiosarcoma, and 6 epithelial type MPMs. The regimens of the IPHC were CDDP (300 mg) plus saline (n = 12), CDDP (100 mg) plus saline (n = 1), and CDDP (300 mg) plus distilled water (n = 1). The operation and IPHC time was 204 ± 70 and 59 ± 19 minutes, respectively. Intraoperative complication was observed in 2 lung injuries due to exfoliation of the pleural adhesion in the LC group. Blood loss was 292 ± 365 ml. The postoperative complication, i.e., subcutaneous emphysema, was observed as grade 2 pulmonary fistula (7.1%, 1/14), which was significantly observed in the LC group (1/8, 12.5%) compared to the MPM group (0/8, 0%) (p = 0.040). The hematological toxicity of more than grade 3 was observed in only one case of anemia (7.1%, 1/14) and in the LC group (25%, 1/8). The grade 3 anemia (25%, 1/8) and grade 2 neutropenia (25%, 1/8) in the LC group were significantly observed compared to those in the MPM group (0%, 0/6), respectively (p = 0.040). The postoperative cytology of the malignant cells in the pleural effusion resulted in the negative (n = 6), positive (n = 7), and not evaluated (n = 1), and the control rate was calculated to be 46.2% (6/13). There was no significant difference between the two groups (p = 0.083), that is, 42.9% (3/7) in the LC group and * Corresponding author.T. Ayabe et al. 204 50.0% (3/6) in the MPM group. For the postoperative amounts of the pleural effusion, reduction (n = 10), unchanged (n = 3), and not evaluated (n = 1), the control rate was calculated to be 76.9% (10/13). There was a significant difference between the two groups (p = 0.042), that is, 71.4% (5/7) in the LC group and 83.3% (5/6) in the MPM group. Conclusion: The IPHC treatment resulted in no major complications, and fewer adverse events of more than grade 3. The outcome of the IPHC was safety, and a very effective control of the malignant cells and pleural effusion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes, Safety and Efficacy of Intrapleural Hyperthermic Chemotherapy for Thoracic Malignant Diseases with Pleural Effusion

Ayabe¹,

Tomita²,

Chosa³

et al. 2016

JCT

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“…It is suggested that hyperthermia may cause apoptotic effect on tumor cells. [18] It has also been showed that hyperthermia increases penetration of chemotherapeutic agents to tumor cells. [11][12][13]17,18] Sugarbaker et al [20] investigated the effect of HIPEC in low-risk patients with MPM undergoing surgical macroscopic complete resection.…”

Section: Discussionmentioning

confidence: 99%

“…The effect of the modality can be attributable to the apoptotic effect of high temperature on tumor cells. [18] Also, some authors approved its potentiating effect on penetration of chemotherapeutic agents. [11][12][13]17,18] Sugarbaker et al [20] published their results on the effect of HIPEC among low-risk patients.…”

Section: Discussionmentioning

confidence: 99%

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Can hyperthermic intrathoracic perfusion chemotherapy added to lung sparing surgery be the solution for malignant pleural mesothelioma?

Işık¹

2016

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada, malign plevral mezotelyomalı hastalarda akciğer koruyucu sitoredüktüf cerrahiye eklenen hipertermik toraks içi perfüzyon kemoterapisinin sağkalım açısından ekstraplevral pnömonektomiye üstün olup olmadığı araştırıldı.Ça lış ma pla nı: Ocak 2002 -Haziran 2014 tarihleri arasında kliniğimizde yatan malign plevral mezotelyomalı 73 hastanın (35 erkek, 38 kadın; ort yaş 55.9±12.3 yıl; dağılım 20-80 yıl) verileri retrospektif olarak incelendi. Hastalar grup 1 (n=20, yalnız ekstraplevral pnömonektomi), grup 2 (n=17, yalnızca palyatif tedavi) ve grup 3 (n=36, akciğer koruyucu sitoredüktif cerrahi artı hipertermik toraks içi perfüzyon kemoterapisi) olmak üzere üç gruba ayrıldı. Tedavi grupları, sağkalım ve hastalıksız süre açısından karşılaştırıldı. Bul gu lar:Medyan sağkalımlar grup 1, 2 ve 3'te sırası ile beş, altı ve 27 ay idi. İki yıllık sağkalım grup 3'te %56.5 iken grup 1'de %15 ve grup 2'de %17.6 idi (p= 0.01). Bununla birlikte, dört yıllık sağkalım oranı grup 3'te (%14.6) grup 1 (%0) ve 2 (%11.8) ile karşılaştırıldığında anlamlı olarak daha yüksekti. Sağkalım zamanı grup 3'te epitelyal ve bifazik histolojiler arasında anlamlı olarak farklı değildi (sırası ile medyan 28 ve 27 ay).So nuç:Bu çalışmanın sonuçları, malign plevral mezotelyomada akciğer koruyucu sitoredüktif cerrahiye eklenen hipertermik toraks içi perfüzyon kemoterapisinin yalnız ekstraplevral pnömonektomi veya palyatif tedaviye göre daha az morbidite ile daha uzun sağkalım sağladığını göstermektedir. Epitelyal olmayan malign plevral mezotelyoma olgularında da akciğer koruyucu sitoredüktif cerrahiye eklenen hipertermik toraks içi perfüzyon kemoterapisinin kullanılmasını önermekteyiz.Anah tarsöz cük ler: Hipertermik perfüzyon kemoterapisi; mezotelyoma; plevra; cerrahi. ABSTRACTBackground: This study aims to investigate whether hyperthermic intrathoracic perfusion chemotherapy added to lung sparing cytoreductive surgery is superior to extrapleural pneumonectomy in patients with malignant pleural mesothelioma in terms of survival.

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Intrapleural Therapy: from BCG to Therapeutic Genes

Haas¹,

Sterman²

2006

Thoracic Endoscopy: Advances in Interventional Pulmonology

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Intrapleural Hyperthermic Perfusion With Chemotherapy Increases Apoptosis in Malignant Pleuritis

Cited by 35 publications

References 20 publications

Clinical Outcomes, Safety and Efficacy of Intrapleural Hyperthermic Chemotherapy for Thoracic Malignant Diseases with Pleural Effusion

Clinical Outcomes, Safety and Efficacy of Intrapleural Hyperthermic Chemotherapy for Thoracic Malignant Diseases with Pleural Effusion

Can hyperthermic intrathoracic perfusion chemotherapy added to lung sparing surgery be the solution for malignant pleural mesothelioma?

Intrapleural Therapy: from BCG to Therapeutic Genes

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