Good Doctor – Hyperthermic Perfusion | Controlling Malignant Pleural Effusion, Improving Patients’ Quality of Life and Survival Duration

Good Doctor – Hyperthermic Perfusion | Controlling Malignant Pleural Effusion, Improving Patients’ Quality of Life and Survival Duration

Malignant pleural effusion is a common and serious complication of malignant tumors, and its health risks cannot be underestimated. According to the "2025 Chinese Society of Clinical Oncology (CSCO) Guidelines for the Diagnosis and Treatment of Malignant Pleural Effusion": Malignant pleural effusion refers to the accumulation of fluid in the pleural cavity caused by direct invasion of the pleura by malignant tumor cells, involvement of the lymphatic system, or distant metastasis to the thoracic cavity. Depending on the origin and histopathological type of the tumor, malignant pleural effusion can be classified into several subtypes. The most common type is primary malignant pleural effusion, which results from direct invasion of the pleura by malignant tumor cells and accounts for more than 70% of all cases of malignant pleural effusion. The second most common type is secondary malignant pleural effusion, which arises when malignant tumor cells metastasize to the lymphatic system or distant organs and subsequently enter the thoracic cavity via the lymphatic fluid or bloodstream. According to statistics, China sees approximately 200,000 new cases of malignant pleural effusion each year, with lung cancer and breast cancer being the leading causes, accounting for 45% and 30% of all patients, respectively.

1. The Dangers of Malignant Pleural Effusion: A “Lifelong Shackle” for Advanced Cancer Patients

The symptoms caused by malignant pleural effusion are highly debilitating: more than 80% of patients experience shortness of breath, 60% suffer from chest pain, and 50% exhibit symptoms such as coughing—all of which severely impact their quality of life. As the volume of effusion increases, it can also trigger electrolyte imbalances and hypoproteinemia, eventually leading to multi-organ failure. Even more critically, cytological examination of malignant pleural effusion reveals that the positive rate for cancer cells ranges from 70% to 80%, often signaling disease progression and a poorer prognosis, effectively becoming a “shackles on life” for patients with advanced-stage tumors.

2. The Good Doctor’s thermal perfusion is the most effective approach to addressing malignant pleural effusion.

Good Doctor—Thermal Perfusion Chemotherapy leverages the principle of localized hyperthermia combined with chemotherapy to prevent and treat cancer cell implantation and metastasis, as well as to inhibit the occurrence and progression of malignant effusions. The procedure can be performed either through a catheter directly placed during surgery or via a cavity drainage catheter left in place after surgery. Alternatively, under non-surgical conditions, a catheter can be inserted using an extracorporeal puncture technique (under local subcutaneous anesthesia). The perfusion fluid (saline solution) is rapidly heated to a preset temperature within the Good Doctor thermal perfusion machine before being injected into the body cavity. Heat-sensitive chemotherapy drugs can also be added to the perfusion fluid. Under continuous dynamic monitoring and feedback regulation by a computer system, the temperature of the perfusion fluid inside the body cavity is maintained at a therapeutic level of 42.5°C, ensuring constant temperature and pressure throughout a 60-minute circulation cycle. This synergistic combination of chemotherapy and hyperthermia effectively targets and kills freely dispersed cancer cells or tiny metastatic lesions throughout the body cavity, addresses the root cause of malignant effusion formation, and significantly improves patients' quality of life and survival rates.

Hyperthermic Intrathoracic Chemotherapy (HITHOC) is a therapeutic approach that combines localized hyperthermia with chemotherapy for primary malignant tumors within the thoracic cavity (such as malignant pleural mesothelioma) and/or metastatic malignant tumors in the thoracic cavity. HITHOC can be used either alone as palliative treatment for patients with advanced-stage thoracic tumors, or in combination with cytoreductive surgery (CRS). Commonly employed CRS procedures for thoracic tumors include pleurectomy/decortication (P/D) or extended pleurectomy/decortication (eP/D).

3. Differentiated Advantages of Hyperthermic Intrathoracic Chemotherapy (HITHOC) vs. Traditional Chemotherapy

4. Clinical Value of Hyperthermic Perfusion Chemotherapy in the Good Doctor

Advantages of the Clinical Application of Good Doctor Chest Hyperthermic Intrathoracic Chemotherapy (GD-HITHOC)

Rapidly heat the fluid to the set temperature and maintain a constant temperature throughout the perfusion cycle (with real-time display of intrathoracic temperature between 42°C and 42.5°C). Precisely control the perfusion flow rate and velocity to maintain constant intrathoracic pressure, thereby preventing mediastinal shift and associated adverse reactions. Before initiating circulating thermal perfusion, utilize GD-HITHOC’s unique “unidirectional thermal perfusion” function to flush and remove the microenvironment conducive to cancer cell growth within the thoracic cavity—such as growth factors and inflammatory cytokines. This technique can be applied not only during surgical procedures but also at the bedside in oncology wards or treatment rooms. Depending on the patient’s overall condition, HITHOC can be performed multiple times to complete the prescribed course of treatment or until pleural effusion has resolved and recurrence is effectively controlled.

Clinical Treatment Model of GD-HITHOC

Neoadjuvant hyperthermic intrathoracic chemotherapy (NA-HITHOC) before surgery: makes it possible for patients who cannot undergo CRS.

Intraoperative Hyperthermic Intrathoracic Chemotherapy (IO-HITHOC): This procedure prevents implantation and metastasis of free cancer cells that may detach during surgery, while also eliminating microscopic lesions that remain undetected by the naked eye during CRS.

Postoperative Hyperthermic Intrathoracic Chemotherapy (PO-HITHOC): It kills free cancer cells and micrometastases, prevents postoperative recurrence, and improves cancer-free survival.

Palliative HITHOC: A treatment for patients with postoperative recurrence or those in the middle to late stages (who have missed or are unwilling to undergo CRS), aimed at controlling malignant pleural effusion and improving the patient’s quality of life.