title: Effect of hyperthermic intrathoracic chemotherapy (HITHOC) on the malignant pleural effusion: A systematic review and meta-analysis.
abstract: BACKGROUND
  Although hyperthermic intraperitoneal chemotherapy (HIPEC) has been widely used to treat malignant ascites or as a preventive strategy for microscopic carcinomatosis following surgical resection of abdominal tumors, application of hyperthermic intrathoracic chemotherapy (HITHOC) in the treatment of malignant pleural effusion is limited. The objective of the current study was to conduct a systematic review and meta-analysis on the application of HITHOC in the palliative treatment of malignant pleural effusion.
  
  
  METHODS
  After thorough searching of online databases, total 27 articles were included into qualitative systematic review and 5 of them were used to conduct qualitative meta-analysis.
  
  
  RESULTS
  It was found that most of HITHOC was used in combination of cytoreductive surgery (CRS) including pleurectomy/decortication or after surgical resection of primary tumors, which mainly were lung cancer, thymoma or thymic carcinoma, breast cancer, and ovarian cancer. Patients who received HITHOC had significantly longer median survival length compared to the patients without HITHOC (Hedges g = 0.763, P < 0.001). In addition, HITHOC therapy was favored (Hedges g = 0.848, P < 0.001) in terms of median survival length, tumor-free survival rate, with tumor survival rate or Karnofsky performance status (KPS) scale.
  
  
  CONCLUSIONS
  HITHOC is a safe and effective therapy in controlling pleural effusion and increasing patient's survival rate.
authors.affiliation: Department of Respiration, The First Affiliated Hospital, Zhejiang University, Hangzhou Department of Radiology, Jilin Provincial Tumor Hospital, Changchun, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Zhou
authors.forename: Wei
authors.initials: W
authors.lastname: Wu
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Tang
authors.forename: Jianying
authors.initials: J
authors.lastname: Zhou
authors.forename: Yihong
authors.initials: Y
authors.lastname: Shen
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D065426:Cytoreduction Surgical Procedures / Q000379:methods*; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods*; D016066:Pleural Effusion, Malignant / Q000473:pathology / Q000628:therapy; D016019:Survival Analysis; D035423:Thoracic Cavity / Q000473:pathology; D019616:Thoracic Surgical Procedures / Q000379:methods*
chemical_list: D000970:Antineoplastic Agents