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HITHOC for Pleural Mesothelioma: “Safe, Feasible and Effective”

HITHOC for pleural mesotheliomaA newly published study says a localized form of chemotherapy called HITHOC for pleural mesothelioma is “safe, feasible, and effective.”

Researchers from Italy’s University of Pisa conducted the study. They did a thorough review of the medical literature on the procedure since 1994. 

They conclude that HITHOC for pleural mesothelioma after surgery keeps tumors in check and improves survival. The downside is that there is not enough standardization in how doctors use the procedure. 

How HITHOC for Pleural Mesothelioma Works

HITHOC stands for hyperthermic intrathoracic chemotherapy. Standard mesothelioma chemotherapy enters the whole body at once through the bloodstream. That is one reason that many mesothelioma patients on chemotherapy have side effects like nausea and low white blood cell counts. 

HITHOC for pleural mesothelioma is different. It happens during mesothelioma surgery. After surgeons remove as much visible cancer as possible, they rinse the open chest with a heated solution of chemotherapy drugs. The goal is to kill as many residual mesothelioma cells as possible. 

Pleural mesothelioma tumors grow on the membrane around the lungs. They tend to be thin and irregularly shaped which makes it hard for surgeons to remove all of the cancer. HITHOC offers a way to make surgery more complete without causing major side effects.

What Do the Studies Say?

HITHOC is a fairly new option for pleural mesothelioma patients. It is usually only available at larger medical centers where doctors see more cases of mesothelioma. 

The Italian researchers focused on the largest, most thorough studies on HITHOC for pleural mesothelioma. They looked for studies as far back as 1994 which is when doctors first started trying this approach with mesothelioma patients. 

“From 1994 to date, different authors experimented [with] HITHOC following a cytoreductive surgery in MPM, obtaining in most cases a good local control and a better overall survival associated [with a] very low complication rate,” writes lead author Vittorio Aprile in the Journal of Clinical Medicine.  

Dr. Aprile and colleagues conclude that HITHOC is a “safe, feasible, and effective” procedure for mesothelioma patients. But there are big differences in how different surgeons use it. For that reason, the  authors say their report is not the final word on this approach. 

“More structured studies are needed to reach a unanimous consensus on this technique,” writes Dr. Aprile. 

In the meantime, multiple studies show mesothelioma patients have better outcomes at more experienced medical centers. These centers are more likely to offer advanced techniques like HITHOC for pleural mesothelioma and access to clinic trials. CLICK HERE if you need help finding a mesothelioma specialist in your area. 


Aprile, V, et al, “Hyperthermic Intrathoracic Chemotherapy for Malignant Pleural Mesothelioma: The Forefront of Surgery-Based Multimodality Treatment”, August 25, 2021, Journal of Clinical Medicine, https://www.mdpi.com/2077-0383/10/17/3801


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