A new review published in the World Journal of Surgical Oncology found hyperthermic intrathoracic chemotherapy (HITHOC) to be a safe and effective treatment for mesothelioma.

More specifically, researchers concluded that patients who underwent the HITHOC procedure  after surgery lived longer than those who only received surgery.

During HITHOC, doctors deliver heated chemotherapy directly into the chest cavity immediately after tumor-removing surgery. The high temperature enhances the effectiveness of chemotherapy drugs, helping to destroy microscopic cancer cells and prevent the cancer from coming back. The procedure typically lasts 60–90 minutes and is performed while the patient is still under anesthesia.

By combining surgery with HITHOC, patients battling mesothelioma may have a better chance of long-term survival.

What Did the HITHOC Researchers Look At?

The research team examined data from six previously published studies involving HITHOC treatment for pleural mesothelioma, a specific type of this cancer that develops in the lung lining.

They looked at patients who had surgery with or without HITHOC. Most had pleurectomy with decortication (P/D), a lung-sparing surgery. Only a few had extrapleural pneumonectomy (EPP), a more invasive procedure that removes an entire lung.

Key variables across the HITHOC mesothelioma studies included:

  • Duration and temperature of the HITHOC treatment
  • Types and doses of chemotherapy drugs used
  • Timing of chemotherapy in relation to surgery

Despite differences in treatment details, most studies showed improved survival rates in the patients who received HITHOC.

Not every patient qualifies for HITHOC. It’s generally recommended for those healthy enough to undergo surgery and whose cancer is confined to the chest cavity. Your care team will determine if this treatment is right for you.

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Key Findings on HITHOC Treatment for Pleural Mesothelioma

Results showed that adding HITHOC after surgery may significantly improve life expectancy in patients with pleural mesothelioma.

Here’s what the review found:

  • Patients who had surgery plus HITHOC lived between 13 and 35 months, compared to 11 to 22.8 months for those who had surgery alone.
  • In several studies, patients who received HITHOC had more time before their cancer returned (progression-free survival).
  • One study found that patients treated with EPP and radiation therapy lived longer (29 months) than those treated with HITHOC (11 months), suggesting that HITHOC may not be superior in every case.

The researchers emphasized the need for more clinical trials to better understand how HITHOC compares with other mesothelioma treatments and who may benefit most.

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What the HITHOC Review Means for Mesothelioma Patients

For patients who can get surgery, adding HITHOC may help them live months or even years longer compared to surgery alone.

Standard treatment for pleural mesothelioma typically includes surgery, chemotherapy, and sometimes radiation. HITHOC is considered an emerging therapy. However, this research supports it as a promising follow-up therapy to improve survival and quality of life.

Mesothelioma patients often face limited treatment options, so this approach may offer a stronger and more effective starting point for care.

HITHOC is currently available at select cancer centers and often as part of clinical trials. A mesothelioma specialist can help determine if you qualify.

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References
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  2. Ambrogi, M. C., Lucchi, M., Ribechini, A., & Melfi, F. (2024). Hyperthermic intrathoracic chemotherapy after cytoreductive surgery for malignant pleural mesothelioma: Is it safe and effective? Updates in Surgery. https://doi.org/10.1007/s13304-024-01986-1. Retrieved from: https://link.springer.com/article/10.1007/s13304-024-01986-1.
  3. Billeci, D., Raffaele, L., Ciriaco, P., & Negri, G. (2021). Hyperthermic intrathoracic chemotherapy in patients with malignant pleural mesothelioma after cytoreductive surgery: A single-center experience. Clinics in Oncology, 6, 1830. Retrieved from: https://www.clinicsinoncology.com/open-access/hyperthermic-intrathoracic-chemotherapy-in-patients-with-malignant-pleural-mesothelioma-after-9770.pdf.
  4. CancerNetwork. (2024, April 2). HITHOC after surgery appears safe, may improve survival in mesothelioma. Retrieved from: https://www.cancernetwork.com/view/hitoch-after-surgery-appears-safe-may-improve-survival-in-mesothelioma.
  5. Mastrobuoni, E., & Perrone, F. (2024). Hyperthermic intrathoracic chemotherapy in patients with malignant pleural mesothelioma after cytoreductive surgical procedures: A systematic review. Retrieved from: https://www.researchgate.net/publication/390639567_Hyperthermic_intrathoracic_chemotherapy_in_patients_with_malignant_pleural_mesothelioma_after_cytoreductive_surgical_procedures_a_systematic_review.
  6. Van Sandick, J. W., Schats, W., Burgers, J. A., Baas, P., van Tinteren, H., & Wouters, M. W. J. M. (2021). The use of hyperthermic intrathoracic chemotherapy in the treatment of malignant pleural mesothelioma: A review. Cancers, 13(17), 4381. Retrieved from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8432004/.
  7. Yang, C.-F. J., & Sugarbaker, D. J. (2024). Hyperthermic intrathoracic chemotherapy for pleural mesothelioma: Advances and ongoing challenges. Cancers, 16(8), 1587. Retrieved from: https://www.mdpi.com/2072-6694/16/8/1587.

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