High doses of hyperthermic intrathoracic chemotherapy (HITHOC) help pleural mesothelioma patients. A recent study found that when HITHOC is administered at a high dose, survival rates improve and periods of being disease free increase. HITHOC is the use of chemotherapy during surgery and is an experimental treatment for different types of cancer including mesothelioma. It is similar to a peritoneal mesothelioma treatment that helps patients live around three to five extra years, so researchers are looking to test the pleural mesothelioma version as well. They are trying to find the best possible dosage for pleural mesothelioma patients, so they are testing high doses for treating the disease.
Hyperthermic intrathoracic chemotherapy is a procedure that circulates heated chemotherapy through the chest cavity. It is similar to heated intraperitoneal chemotherapy, which is used for peritoneal mesothelioma. It is administered right after surgery while the patient is under anesthesia. Pleurectomy and decortication surgery is the most common cytoreductive surgery for mesothelioma, so pleural mesothelioma patients typically have surgery after pleurectomy and decortication. Chemotherapy is applied directly to the area containing the tumors during surgery. Pleural mesothelioma is a cancer of the pleural membrane that surrounds the lungs, so pleurectomy and decortication surgery removes this membrane, and then chemotherapy is applied. The chemotherapy usually sits for around a few hours. The chemotherapy kills any remaining cancer cells that surgery cannot remove.
HITHOC is a proven method of increasing survival for mesothelioma patients. When most patients receive HITHOC after surgery for pleural mesothelioma, they live multiple years past their diagnosis. A study found that early-stage patients saw a median survival of 42 months with pleurectomy and decortication surgery and HITHOC. This study looked at the idea of increasing dosage of HITHOC to increase the survival rate of patients. If found to be safe and effective, high doses of HITHOC could be used for treating mesothelioma patients.
There was a collection of 15 studies in the overall study with a total of 598 patients being monitored. There were three groups of patients: one group received the typical surgery followed by HITHOC, one group did not receive HITHOC or surgery, and one group received surgery with a high dosage of HITHOC. The best results were found in the group that received surgery and the higher dosage of HITHOC. The higher dosage group had an average overall survival of 18 to 31 months compared to the regular treatment group which had a survival of 6 to 18 months. Patients in the group who did not receive any treatment had a survival of 5 to 36 months. Based on the study, doctors should be utilizing higher doses of HITHOC alongside cytoreductive surgery for pleural mesothelioma patients.