HITHOC research and programs

New project here on Cirugia de Torax.org: to compile a list of thoracic surgeons and thoracic surgery programs that are investigating and performing HITHOC procedures, but we need your help. Includes clinical trial information.

Since I’ve had enough web traffic and emails to see that I am not the only person that is interested in more news and research in the area of HITHOC, I have started contacting thoracic surgeons and programs that are doing research and treatment using hyperthermic intrathoracic chemotherapy. (I have identified thoracic surgeons through published literature.)

I’ve already contacted several (by email) and hope to hear back soon – so I can pass it on to interested readers.  If you are currently researching this treatment, or know of a thoracic surgery program, please contact me via the site with more specific details.

HITHOC programs – Cytoreductive surgery with Hyperthermic intrathoracic chemotherapy

1.  University Medical Center (Department of Cardiothoracic Surgery) and at the Barmherzige Brüder Regensburg (Department of Thoracic Surgery) – Regensburg, Germany  (more details pending).

1 July 2011

Running into some roadblocks on this project – having a hard time contacting (and receiving replies) from authors researching HITHOC.  Hopefully, I’ll get some more leads soon.

Other Research Programs:

HITHOC (Cytoreductive surgery + hyperthermic chemotherapy

1.  Extrapleural Pneumonectomy /Pleurectomy Decortication, IHOC Cisplatin and Gemcitabine With Amifostine and Sodium Thiosulfate Cytoprotection for Resectable Malignant Pleural Mesothelioma – at Brigham & Womens – study led by Dr. David Sugarbaker (who I have attempted to contact on behalf of the site several times.) This looks to be one of several clinical trial arms for HITHOC/ Hyperthermic chemotherapy for malignant chemotherapy at Brigham and Women’s.

Hyperthermic Chemotherapy only:

1.  Hyperthermia/Thermal Therapy With Chemotherapy to Treat Inoperable or Metastatic Tumors  – at the University of Texas at Houston, TexasClinical trial currently recruiting participants.

2.  Heated Chemotherapy for Cancers That Have Spread to the Chest Cavity – at St. Luke’s Roosevelt Hospital. Currently enrolling participants.

Cytoreductive Surgery with Intraoperative Hyperthermic Intrathoracic Chemotherapy

An introduction to cytoreductive surgery with hyperthermic intrathoracic chemotherapy administrative for the treatment of malignant pleural mesothelioma.

Cytoreductive surgery with Intraoperative Hyperthermic Chemotherapy (HIPEC) has been used for over a decade now for abdominal cancers including metastatic colon cancer (peritoneal carcinomatosis) and malignant peritoneal mesothelioma.  During this lengthy procedure, surgeons remove as much gross disease as possible, and then infuse heated chemotherapy agents directly into the abdominal cavity to kill any residual cancer cells.  One of the benefits of this treatment is that by directly administering chemotherapy to the site of disease – the patient experiences less toxic side effects (versus intravenous or oral ingestion) and higher concentrations can be used, which are more effective at killing the malignant cells.  Research findings have been encouraging, and have shown significant improvement in median survival in comparison to standard treatment.

During my research in Bogotá, Colombia – I interviewed a general surgeon who was responsible for establishing a HIPEC treatment program in a local hospital there.  (There are less than 25 HIPEC treatment centers in the world.)  This spurred my interest in thoracic applications of this procedure (called the Sugarbaker procedure after the inventor, Dr. Paul Sugarbaker, an oncologist.)

In recent years, thoracic surgery has investigated and adopted some of this research for use and treatment of thoracic cancers, in a procedure known as HITHOC.  In thoracic surgery, intrathoracic (inside the chest) administration of heated chemotherapy in the operating room has been used primarily to treat malignant thymomas and malignant pleural mesothelioma.  Results of recent studies have been mixed – with the best results occurring in patients with thymomas.  In patients with mesothelioma, prognosis is dependent on stage.

Rutgers and Bree et. al at the Netherlands Cancer Institute published several additional studies on the subject,  looking at the effectiveness of different chemotherapeutic agents for HITHOC.  Given their extensive experience and knowledge on the subject, I have contacted the researchers at the Netherlands Cancer Institute to invite the authors to submit a guest post.  (I’d rather all of you hear from the experts!)

Additional References: (links when possible)

1. Dutch study using the Sugarbaker procedure for intrathoracic infusion for pleural thymomas and malignant pleural mesothelioma.  Bree et. al (2000) from Chest. Small study with only 14 patients but a nice discussion of the procedure with graphics. Multiple other studies from these authors, as mentioned above.

2. A nice blog that explains the Sugarbaker procedure.

3. Very small Japanese study from 2003 – five patients.  Notably, these patients had a different disease process – lung cancer with pleuritic carcinomatosis. 4 out of five patients demonstrated significant longevity after the procedure with no recurrence.