Cargando…

Narrative review of theoretical considerations regarding HITHOC between past and future

Hyppocrates constructed the medicines-surgery-energy triangle which includes all therapeutical modalities. Hyperthermic intraoperative chemotherapy (HITHOC) is a synergy-based single stage multimodality treatment encompassing the locoregional manifestation of the systemic malignant process. Pleural...

Descripción completa

Detalles Bibliográficos
Autores principales: Molnar, Tamas F., Drozgyik, Andras
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8263867/
https://www.ncbi.nlm.nih.gov/pubmed/34350269
http://dx.doi.org/10.21037/atm-20-5855
_version_ 1783719457285210112
author Molnar, Tamas F.
Drozgyik, Andras
author_facet Molnar, Tamas F.
Drozgyik, Andras
author_sort Molnar, Tamas F.
collection PubMed
description Hyppocrates constructed the medicines-surgery-energy triangle which includes all therapeutical modalities. Hyperthermic intraoperative chemotherapy (HITHOC) is a synergy-based single stage multimodality treatment encompassing the locoregional manifestation of the systemic malignant process. Pleural space, thermal effect, lavage/irrigation and chemotherapy represent the basic science ports of the network hub: HITHOC. The malignant transformation and process of the pleural surface (and underlying lung) challenges space management and tissue control. Thermotherapy without local chemotherapy is insufficient, similar to the normothermic local irrigation aligned with anticancer agents. The local administration of combined heat-transfer fluid and chemotherapy with or without subsequent surgical removal offers reasonable outcome in extensive primary pleural neoplasms (malignant mesothelioma), advanced (> Stage IIIA) NSCLC, functionally inoperable lung cancer and pleural carcinosis from extrathoracic malignancies. Measured by symptom-free survival and the quality of life, HITHOC in its present form, offers a modest yet fully substantiated solution. HITHOC in combination with the local application of targeted therapy and/or immunotherapy administered in the pleural space are currently under investigation. Additional development including new acting substances, their solvents and the means regarding surgical delivery and anesthesiology techniques are sign posts up ahead. Level 2 evidence are required in order to stepping up the recommendation levels, rewriting protocols and guidelines, in which HITHOC earns its revered position in the decision making process it deserves.
format Online
Article
Text
id pubmed-8263867
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher AME Publishing Company
record_format MEDLINE/PubMed
spelling pubmed-82638672021-08-03 Narrative review of theoretical considerations regarding HITHOC between past and future Molnar, Tamas F. Drozgyik, Andras Ann Transl Med Review Article on Hyperthermic Intraoperative Chemotherapy (HITHOC) in Thoracic Surgical Oncology Hyppocrates constructed the medicines-surgery-energy triangle which includes all therapeutical modalities. Hyperthermic intraoperative chemotherapy (HITHOC) is a synergy-based single stage multimodality treatment encompassing the locoregional manifestation of the systemic malignant process. Pleural space, thermal effect, lavage/irrigation and chemotherapy represent the basic science ports of the network hub: HITHOC. The malignant transformation and process of the pleural surface (and underlying lung) challenges space management and tissue control. Thermotherapy without local chemotherapy is insufficient, similar to the normothermic local irrigation aligned with anticancer agents. The local administration of combined heat-transfer fluid and chemotherapy with or without subsequent surgical removal offers reasonable outcome in extensive primary pleural neoplasms (malignant mesothelioma), advanced (> Stage IIIA) NSCLC, functionally inoperable lung cancer and pleural carcinosis from extrathoracic malignancies. Measured by symptom-free survival and the quality of life, HITHOC in its present form, offers a modest yet fully substantiated solution. HITHOC in combination with the local application of targeted therapy and/or immunotherapy administered in the pleural space are currently under investigation. Additional development including new acting substances, their solvents and the means regarding surgical delivery and anesthesiology techniques are sign posts up ahead. Level 2 evidence are required in order to stepping up the recommendation levels, rewriting protocols and guidelines, in which HITHOC earns its revered position in the decision making process it deserves. AME Publishing Company 2021-06 /pmc/articles/PMC8263867/ /pubmed/34350269 http://dx.doi.org/10.21037/atm-20-5855 Text en 2021 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Review Article on Hyperthermic Intraoperative Chemotherapy (HITHOC) in Thoracic Surgical Oncology
Molnar, Tamas F.
Drozgyik, Andras
Narrative review of theoretical considerations regarding HITHOC between past and future
title Narrative review of theoretical considerations regarding HITHOC between past and future
title_full Narrative review of theoretical considerations regarding HITHOC between past and future
title_fullStr Narrative review of theoretical considerations regarding HITHOC between past and future
title_full_unstemmed Narrative review of theoretical considerations regarding HITHOC between past and future
title_short Narrative review of theoretical considerations regarding HITHOC between past and future
title_sort narrative review of theoretical considerations regarding hithoc between past and future
topic Review Article on Hyperthermic Intraoperative Chemotherapy (HITHOC) in Thoracic Surgical Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8263867/
https://www.ncbi.nlm.nih.gov/pubmed/34350269
http://dx.doi.org/10.21037/atm-20-5855
work_keys_str_mv AT molnartamasf narrativereviewoftheoreticalconsiderationsregardinghithocbetweenpastandfuture
AT drozgyikandras narrativereviewoftheoreticalconsiderationsregardinghithocbetweenpastandfuture