胸腔热灌注化疗在胸腔恶性肿瘤治疗中的应用进展OA
Progress of Hyperthermic Intrathoracic Chemotherapy in Treatment of Thoracic Malignant Tumors
胸腔热灌注化疗(HITHOC)是一种结合热疗和药物(如化疗药物、抗血管生成药物、靶向药物或免疫药物)的局部治疗方法,近年来在恶性胸膜间皮瘤、肺癌胸膜转移及胸腺肿瘤胸膜播散等领域取得临床进展.HITHOC作为细胞减灭术的辅助治疗,可改善患者生存并有效控制胸腔积液和胸膜转移,其通过热效应增强药物渗透、诱导细胞凋亡及调节免疫微环境发挥抗肿瘤作用.HITHOC与全身治疗(如化疗、靶向、免疫治疗等)的联合展现协同增效的潜力,但其作为局部治疗手段,在晚期患者的综合治疗体系中应明确其辅助定位,需进一步研究其适应证、标准化流程及长期疗效,并探索方案优化与个体化联合治疗策略.本文深入探讨了制约热疗领域发展的关键瓶颈,如高级别循证医学证据的缺乏、诊断与疗效评价标准的缺失等,并提出了相应的解决思路.
Hyperthermic intrathoracic chemotherapy(HITHOC)is a localized treatment that combines hyperthermia with medications such as chemotherapy,anti-angiogenic agents,targeted therapy,or immun-otherapeutic agents.It has advanced clinical progress for conditions such as malignant pleural mesothelioma,pleural metastasis of lung cancer,and pleural dissemination of thymic tumors.Systematic analyses indicate that as an adjuvant therapy to cytoreductive surgery,HITHOC improves patient survival and effectively controls pleural effusion and pleural metastasis.It exerts antitumor effects by enhancing drug penetration through thermal effects,inducing apoptosis,and modulating the immune microenvironment.HITHOC combined with systemic therapies(e.g.,chemotherapy,targeted therapy,and immunotherapy)demonstrates synergistic potential,but its role as a local treatment should be clearly defined as adjunctive within the comprehensive management of advanced-stage patients.Further research is needed to clarify its indications,standardized protocols,and long-term efficacy and to explore optimized regimens and personalized combination treatment strategies.This review delves into the key bottlenecks hindering the development of hyperthermia therapy,such as the lack of high-level evidence-based medicine and the absence of standardized diagno-stic and efficacy evaluation criteria,and proposes potential solutions.
盛津津;晏菲;马燕凌;孙建海;李黎
430033 武汉,江汉大学附属湖北省第三人民医院肿瘤科430033 武汉,江汉大学附属湖北省第三人民医院肿瘤科430033 武汉,江汉大学附属湖北省第三人民医院肿瘤科430033 武汉,江汉大学附属湖北省第三人民医院肿瘤科430033 武汉,江汉大学附属湖北省第三人民医院肿瘤科
医药卫生
胸腔热灌注化疗胸腔恶性肿瘤恶性胸膜间皮瘤肺癌胸膜转移联合治疗
Hyperthermic intrathoracic chemotherapyThoracic malignant neo-plasmMalignant pleural mesotheliomaLung cancer pleural metastasisCom-bination therapy
《肿瘤防治研究》 2026 (6)
440-447,8
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