Trimodality Therapy With Induction Chemotherapy Followed by Extrapleural Pneumonectomy and Adjuvant High-Dose Hemithoracic Radiation for Malignant Pleural Mesothelioma

Perrot, Marc de; Feld, Ronald; Cho, J.; Bezjak, Andrea; Anraku, Masaki; Burkes, Ronald L.; Roberts, Heidi C.; Tsao, Ming‐Sound; Leighl, Natasha B.; Keshavjee, Shaf; Johnston, Michael

doi:10.1200/jco.2008.17.5604

Cited by 222 publications

(169 citation statements)

References 25 publications

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“…The full protocol could be applied in 50% of patients. Pathological nodal staging was a significant predictor of survival, patients with N0 disease obtaining a 5-year disease-free survival of 54% [42].…”

Section: Combined-modality Therapymentioning

confidence: 99%

“…The incidence of empyema (16%) and bronchopleural fistula (9.5%) were higher than that observed Following the significant results of chemotherapy trials with anti-folate drugs, induction therapy comprising pemetrexed was evaluated to improve results with the hope of substantially increasing overall survival. In a retrospective study of trimodal therapy, 60 patients underwent induction chemotherapy (cisplatin/anti-folate in 30 patients), followed by EPP and post-operative radiotherapy to o50 Gy [42]. The full protocol could be applied in 50% of patients.…”

Section: Combined-modality Therapymentioning

confidence: 99%

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Multimodal management of malignant pleural mesothelioma: where are we today?

Schil

Opitz²,

Weder³

et al. 2014

European Respiratory Journal

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The prognosis of patients with malignant pleural mesothelioma remains poor and although it is clear that multimodal therapy is necessary to improve long-term results, precise treatment schemes have not yet been unequivocally established. Single-modality therapy does not have a major impact on long-term survival and combined-modality therapies are being further evaluated. However, the relative contributions of chemotherapy, radiotherapy and surgery have not been clearly determined at the present time. Moreover, the extent of resection and precise surgical procedure remain a highly debated topic. To better compare and combine results from different institutions and trials, uniform definitions of surgical procedures including extrapleural pneumonectomy and different forms of pleurectomy have recently been introduced. Due to the relatively higher morbidity and mortality of extrapleural pneumonectomy, there is currently a shift towards pleurectomy/decortication when a macroscopic complete resection of all tumour can be obtained by this procedure. In most recent trials, induction chemotherapy was administered to improve surgical resection rates but pathological complete responses are infrequently observed. The role of post-operative radiotherapy has to be further elucidated.Further treatment options that are currently explored include hyperthermic intrapleural chemotherapy, immunotherapy, gene therapy and photodynamic therapy. However, no randomised comparisons are available yet. @ERSpublications Treatment of malignant pleural mesothelioma remains controversial

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Section: Combined-modality Therapymentioning

confidence: 99%

Section: Combined-modality Therapymentioning

confidence: 99%

Multimodal management of malignant pleural mesothelioma: where are we today?

Schil

Opitz²,

Weder³

et al. 2014

European Respiratory Journal

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“…According to this study, the presence of N2 disease was a significant marker of poor outcome, despite completion of the entire trimodality regimen. [12]. By multivariable analyses, significant differences in overall survival were seen for: T4 versus T3 and T3 versus T2 but not T2 versus T1; N0 versus N1 and N2 but not N1 versus N2; stages III and IV versus I but not II versus I; epithelioid histology versus other; age of female versus age of male; and palliative versus curative-intent surgery [13].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors in Patients with Malignant Pleural Mesothelioma

Курченков¹,

Kurchin²,

Zharkov³

2015

Int J Biomed

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The aim of the present study was to examine the factors of prognosis in patients with malignant pleural mesothelioma (MPM) after combined and multimodality treatment, including the prognostic significance of preoperative intrapleural perfusion hyperthermo-chemotherapy (IPHC).Material and Methods: The study included 20 patients (11 men and 9 women) aged from 30 to 70 years (mean age 51.9±8.5 years) who underwent surgical treatment for MPM. The diagnosis of MPM was verified by immunohistochemical data. The patients were divided into two groups. Group 1 included 9 patients who underwent combined treatment that included the extrapleural pneumonectomy (EPP) and 4 courses of adjuvant chemotherapy. Group 2 included 11 patients who received multimodality treatment (IPHC, EPP, and 4 courses of adjuvant chemotherapy). All patients were followed prospectively at threemonthly intervals for the first year and six-monthly thereafter until the last time of contact or death. Statistical analysis was performed by using Kaplan-Meier method and the log-rank test. Cox-regression model was used for multivariate analysis.Results: Patient's age over 60 years and the sarcomatoid type of the tumor can be regarded as prognostic factors for poor survival in patients with MPM who underwent EPP. Application of IPHC as a part of a multimodality treatment enhances the survivability of MPM patients.

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“…Wyniki dotychczasowych badań II fazy, w których w wybranych grupach chorych kojarzono indukcyjną chemioterapię z miejscowymi metodami, są obiecujące [153][154][155][156]. Postępowanie takie można rozważyć u wybranych chorych w I-III stopniu zaawansowania i bez przerzutów w węzłach chłonnych śródpiersia.…”

Section: Chemioterapia W Złośliwym Międzybłoniaku Opłucnejunclassified

Rola systemowych metod leczenia u chorych na niedrobnokomórkowego raka płuca i złośliwego międzybłoniaka opłucnej: Uaktualnione zalecenia ekspertów

Jassem

Biernat

Bryl

et al. 2014

Advances in Respiratory Medicine

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Rak płuca jest w Polsce najczęstszą przyczyną zgonów nowotworowych. Około 85% wszystkich nowotworów płuca stanowi rak niedrobnokomórkowy (NDRP), w którym leki cytotoksyczne i ukierunkowane molekularnie odgrywają coraz większą rolę. W pracy przedstawiono oparte na obecnej wiedzy zalecenia dotyczące stosowania tych metod w praktyce klinicznej u chorych na NDRP oraz na złośliwego międzybłoniaka opłucnej.

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Trimodality Therapy With Induction Chemotherapy Followed by Extrapleural Pneumonectomy and Adjuvant High-Dose Hemithoracic Radiation for Malignant Pleural Mesothelioma

Cited by 222 publications

References 25 publications

Multimodal management of malignant pleural mesothelioma: where are we today?

Multimodal management of malignant pleural mesothelioma: where are we today?

Prognostic Factors in Patients with Malignant Pleural Mesothelioma

Rola systemowych metod leczenia u chorych na niedrobnokomórkowego raka płuca i złośliwego międzybłoniaka opłucnej: Uaktualnione zalecenia ekspertów

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