RT Journal Article
SR Electronic
T1 Does cytoreduction surgery and hyperthermic intrathoracic chemotherapy prolong survival in patients with N0–N1 nonsmall cell lung cancer and malignant pleural effusion?
JF European Respiratory Review
JO EUROPEAN RESPIRATORY REVIEW
FD European Respiratory Society
SP 190018
DO 10.1183/16000617.0018-2019
VO 28
IS 153
A1 Marcello Migliore
A1 Marco Nardini
YR 2019
UL http://err.ersjournals.com/content/28/153/190018.abstract
AB Introduction Debulking surgery and hyperthermic intrathoracic chemotherapy (HITHOC) has been successfully used in the treatment of thoracic tumours. Few authors report on the feasibility of its use in patients with lung cancer and malignant pleural effusion. The aim of this study was to evaluate the efficacy and results of debulking surgery and HITHOC in the treatment of selected patients with nonsmall cell lung cancer (NSCLC) and malignant pleural effusion.Methods A systematic review was conducted in MEDLINE in accordance with PRISMA guidelines. The word search included: “hyperthermic intrathoracic chemotherapy and/or HITHOC or hyperthermic intrapleural”. Inclusion criteria were only those studies reporting a sufficient amount of data on HITHOC and surgery for lung cancer. Single case reports and review articles were excluded.Results 20 articles were selected as they related to the topic of HITHOC and lung cancer. Most were from China (n=8) and Japan (n=6). Only four out of the 20 articles had sufficient data for this review. In total, data for 21 patients were collected. Debulking surgery ranged from wedge resection to pneumonectomy and pleurectomy. Mean survival was 27 months and median survival was 18 months (range 1–74 months). 13 patients out of 21 (62%) were alive at 1 year and six (28.5%) were alive at 2 years. 10 patients were still alive at the time of the respective publication in the 21 patients included. Systemic toxicity and treatment-related mortality were nil. There were insufficient data to perform a meta-analysis.Conclusion Although reported survival in this systematic review is encouraging, available evidence concerning debulking surgery and HITHOC in N0–N1 NSCLC with malignant pleural effusion is weak. Better evidence in the form of a randomised controlled trial is mandatory.Patients with pleural effusion and lung cancer have a poor survival (3–12 months). Debulking surgery and HITHOC shows 62% survival at 1 year and 28.5% at 2 years. Evaluation of this promising novel therapeutic approach in the form of an RCT is mandatory. http://bit.ly/2WPbCXS