{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:21:47Z","timestamp":1760059307122,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T00:00:00Z","timestamp":1748822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Pressurized intra-thoracic aerosol chemotherapy (PITAC) is a novel and promising strategy for the treatment of malignant pleural effusion (MPE). PITAC enables effective pleurodesis while potentially exerting an antineoplastic effect by delivering chemotherapeutic agents as a therapeutic aerosol into the thoracic cavity via a nebulizer. Our preliminary study involved nine patients with unresectable pleural mesothelioma (PM) treated with PITAC. Among them, one case was particularly emblematic for demonstrating notable oncological improvements in addition to well-known palliative benefits. This patient underwent two PITAC procedures, one year apart, without perioperative complications. Redo pleural biopsies from both previous and new sites revealed only fibrous tissue and inflammatory cells, with no evidence of malignancy. Beyond achieving pleurodesis, PITAC\u2014by combining cytotoxic and sclerosing effects\u2014may offer effective local antineoplastic control and represent a promising avenue for enhancing loco-regional therapy in PM.<\/jats:p>","DOI":"10.3390\/medsci13020072","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T12:27:09Z","timestamp":1748867229000},"page":"72","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Twice as Effective? Pressurized Intra-Thoracic Aerosol Chemotherapy: New Frontiers in Pleural Mesothelioma"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9291-5619","authenticated-orcid":false,"given":"Maria Giovanna","family":"Mastromarino","sequence":"first","affiliation":[{"name":"Division of Thoracic Surgery, Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Guerrini","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Guerrieri","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianmarco","family":"Elia","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Lenzini","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8538-1719","authenticated-orcid":false,"given":"Vittorio","family":"Aprile","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy"},{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9258-3466","authenticated-orcid":false,"given":"Greta","family":"Al\u00ec","sequence":"additional","affiliation":[{"name":"Unit of Pathological Anatomy, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University Hospital of Pisa, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8818-6553","authenticated-orcid":false,"given":"Stylianos","family":"Korasidis","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcello Carlo","family":"Ambrogi","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy"},{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9909-6820","authenticated-orcid":false,"given":"Marco","family":"Lucchi","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Cardiac, Thoracic and Vascular Department, University Hospital of Pisa, 56124 Pisa, Italy"},{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56124 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,2]]},"reference":[{"key":"ref_1","first-page":"CD010529","article-title":"Interventions for the management of malignant pleural effusions: A network meta-analysis","volume":"5","author":"Clive","year":"2016","journal-title":"Cochrane Database Syst. 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