Michael Ried1, Martin Eichhorn2, Hauke Winter2, Uwe Grützner3, Michael Lindner4, Rudolf A Hatz3, Benedikt Haager5, Bernward Passlick5, Thomas Galetin6, Alberto Lopez-Pastorini6, Erich Stoelben6, Hans-Stefan Hofmann1,7. 1. Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Deutschland. 2. Chirurgische Abteilung, Thoraxklinik am Universitätsklinikum Heidelberg, Deutschland. 3. Thoraxchirurgisches Zentrum München, Klinikum der Universität München, Deutschland. 4. Asklepios Fachkliniken München-Gauting, Klinikum der Universität München, Thoraxchirurgisches Zentrum München, Deutschland. 5. Klinik für Thoraxchirurgie, Universitätsklinikum Freiburg, Deutschland. 6. Lungenklinik, Lehrstuhl für Thoraxchirurgie, Private Universität Witten Herdecke, Kliniken der Stadt Köln gGmbH, Deutschland. 7. KH Barmherzige Brüder Regensburg, Klinik für Thoraxchirurgie, Deutschland.
Abstract
INTRODUCTION: During the last few years, hyperthermic intrathoracic chemotherapy (HITOC) has been performed in several departments for thoracic surgery in Germany. The objective of this expert recommendation is to provide elementary recommendations for a standardised HITOC treatment, which are based on clinical experiences and research data. METHODS: Between October and December 2018, a group of experts for thoracic surgery in five departments of thoracic surgery developed recommendations for the HITOC procedure in Germany. These experts were selected by the latest national survey for HITOC and had the most clinical experience with HITOC. All recommendations are based on clinical experience, the experts' research data and recent literature. RESULTS: All recommendations were evaluated by all participating departments in one consensus survey. Finally, a total of six main conclusions including a total of 17 recommendations were developed. For each recommendation, the strength of the consensus is presented in percentages. 100% agreement was established for nomenclature, technique, the chemotherapeutic agent, the perioperative management, the safety measures and the indications for HITOC. All experts recommended cisplatin as the first choice chemotherapeutic agent for HITOC. The dosage of cisplatin is specified in mg/m2 body surface area (BSA) and should be between 150 and 175 mg/m2 BSA. The volume of the perfusion fluid (approximately 4 - 5 l) seems to play a role for the concentration gradient of cisplatin and should therefore also be taken into account. CONCLUSIONS: These expert recommendations provide a standardised and consistent implementation of the HITOC procedure. On this basis, postoperative complications associated to HITOC should be reduced and comparison of the results should be improved. Georg Thieme Verlag KG Stuttgart · New York.
INTRODUCTION: During the last few years, hyperthermic intrathoracic chemotherapy (HITOC) has been performed in several departments for thoracic surgery in Germany. The objective of this expert recommendation is to provide elementary recommendations for a standardised HITOC treatment, which are based on clinical experiences and research data. METHODS: Between October and December 2018, a group of experts for thoracic surgery in five departments of thoracic surgery developed recommendations for the HITOC procedure in Germany. These experts were selected by the latest national survey for HITOC and had the most clinical experience with HITOC. All recommendations are based on clinical experience, the experts' research data and recent literature. RESULTS: All recommendations were evaluated by all participating departments in one consensus survey. Finally, a total of six main conclusions including a total of 17 recommendations were developed. For each recommendation, the strength of the consensus is presented in percentages. 100% agreement was established for nomenclature, technique, the chemotherapeutic agent, the perioperative management, the safety measures and the indications for HITOC. All experts recommended cisplatin as the first choice chemotherapeutic agent for HITOC. The dosage of cisplatin is specified in mg/m2 body surface area (BSA) and should be between 150 and 175 mg/m2 BSA. The volume of the perfusion fluid (approximately 4 - 5 l) seems to play a role for the concentration gradient of cisplatin and should therefore also be taken into account. CONCLUSIONS: These expert recommendations provide a standardised and consistent implementation of the HITOC procedure. On this basis, postoperative complications associated to HITOC should be reduced and comparison of the results should be improved. Georg Thieme Verlag KG Stuttgart · New York.
Authors: Till Markowiak; Michael Koller; Florian Zeman; Gunnar Huppertz; Hans-Stefan Hofmann; Michael Ried Journal: BMJ Open Date: 2020-07-20 Impact factor: 2.692