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Der Chirurg

, Volume 81, Issue 6, pp 557–562 | Cite as

Zytoreduktive Chirurgie und hypertherme intrathorakale Chemotherapieperfusion

  • H.-S. HofmannEmail author
  • K. Wiebe
Übersichten

Zusammenfassung

Seit wenigen Jahren wird zusammen mit der Zytoreduktion von primären und sekundären Tumoren der Pleura eine hypertherme intrathorakale Chemotherapieperfusion (HITHOC) zur Verbesserung der lokalen Tumorkontrolle durchgeführt. Gegenüber der einfachen Instillation von Chemotherapeutika in den Pleuraraum, stellt die in nur einigen Zentren der Welt angewandte chirurgische Resektion von Pleuratumoren mit gleichzeitiger hyperthermer Perfusion eine effektivere Behandlungsmethode dar. Durch die intraoperative Anwendung ist eine lokale homogene Verteilung des Zytostatikums mit deutlich höherer Konzentration gegenüber der systemischen Chemotherapie möglich. Dabei bietet die Hyperthermie zusätzliche Vorteile durch eine erhöhte Ansprechrate des Zytostatikums sowie auch durch synergistische antineoplastische Effekte. Voraussetzung für den gefahrlosen Einsatz dieses Verfahrens ist die Beachtung perioperativer Sicherheitsbestimmungen. Durch eine deutlich verminderte Morbidität und Mortalität nach Zytoreduktion und HITHOC bietet dieses Verfahren eine gute Alternative für selektionierte Patienten, bei denen radikale Resektionsverfahren (extrapleurale Pneumonektomie) nicht indiziert sind.

Die HITHOC stellt somit eine neue zusätzliche Therapieoption in der multimodalen Behandlung von Patienten mit primären und sekundären Tumoren der Pleura dar.

Schlüsselwörter

Thoraxchirurgie Hypertherme intrathorakale Chemotherapieperfusion Zytoreduktion Pleuratumoren Multimodale Behandlung 

Cytoreductive surgery and hyperthermic intrathoracic chemotherapy perfusion

Abstract

Recently cytoreductive surgery of primary and secondary pleural tumors has been combined with hyperthermic intrathoracic chemotherapy perfusion (HITHOC) for better local tumor control. In comparison to simple instillation of chemotherapeutic agents into the pleural cavity, the combination of surgical resection of pleural tumors and simultaneous HITHOC seems to be a more effective treatment. Intra-operative perfusion allows an improved distribution of the drug in the pleural space and a higher local concentration of the chemotherapeutic agents in contrast to systemic chemotherapy. Additional advantages of HITHOC are a better response to chemotherapeutic agents and synergistic antineoplastic effects. A prerequisite for safe application of HITHOC is compliance with safety regulations. Due to the reduction in morbidity and mortality this new concept is a valuable alternative for selected patients who do not undergo radical resection (e.g. extrapleural pneumonectomy).

HITHOC is an additional therapeutic option in the multimodal treatment of patients with primary or secondary tumors of the pleura.

Keywords

Thoracic surgery Hyperthermic intrathoracic chemotherapy perfusion Cytoreductive surgery Pleural tumors Multimodal treatment 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Abteilung für ThoraxchirurgieUniversitätsklinikum RegensburgRegensburgDeutschland
  2. 2.Klinik für Thoraxchirurgie des Krankenhauses Barmherzige Brüder RegensburgRegensburgDeutschland

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