1 Answers
Hyperthermic intrathoracic chemotherapy is part of a surgical strategy employed in the treatment of various pleural malignancies. The pleura in this situation could be considered to include the surface linings of the chest wall, lungs, mediastinum, and diaphragm. HITOC is the chest counterpart of HIPEC. Traditionally used in the treatment of malignant mesothelioma, a primary malignancy of the pleura, this modality has recently been evaluated in the treatment of secondary pleural malignancies.
Metastases to the pleural surface from any primary tumor represents Stage IV disease which carries in general an extremely poor prognosis. In addition; in highly selected situations the pleura can be involved by local spread or “seeding” from thoracic tumors such as lung, esophageal, and thymic cancers.
Secondary pleural malignancies include metastasis from distant primary tumors including breast, colon, ovarian, uterine and renal cell carcinoma among others; as well as certain sarcomas and pseudomyxoma peritonei.
Treatment options for such advanced diseases are limited to systemic chemotherapy, radiation, and supportive care measures. These may include management for shortness of breath due to recurrent, symptomatic malignant pleural effusions.