Cyberknife radiosurgery for focal paravertebral recurrence after radical pleurectomy/decortication in malignant pleural mesothelioma

Lang-Lazdunski, Loı̈c; Barrington, Sally F.; Billè, Andrea; Bondiau, P.-Y.

doi:10.1093/ejcts/ezr263

Cited by 6 publications

(10 citation statements)

References 9 publications

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“…Regarding the handling of the pleural drain after completing the pleurodesis, five studies described raising the drain above the level of the patient, two authors raised the drain above the level of the patient and removed the suction, one study reported keeping the suction while raising the drain, and in another study the drain was clamped for 30 min and was then connected with an underwater seal. It is worth mentioning that in the last study all patients had a second drain which was left unclamped without suction 25 …”

Section: Resultsmentioning

confidence: 97%

“…Two studies only included patients with a confirmed “dead space” on the chest x‐ray, 3,22 and in a third study most patients had a “dead space” 24 . In two other studies the authors did not perform blood pleurodesis in patients with a “dead space” 21,25 . Four studies reported that more than one application of blood was necessary in some cases, 22–24 with one study reporting up to four applications in one patient 6 …”

Section: Resultsmentioning

confidence: 99%

“… 24 In two other studies the authors did not perform blood pleurodesis in patients with a “dead space”. 21 , 25 Four studies reported that more than one application of blood was necessary in some cases, 22 , 23 , 24 with one study reporting up to four applications in one patient. 6 …”

Section: Resultsmentioning

confidence: 99%

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Autologous blood pleurodesis for the treatment of postoperative air leaks. A systematic review and meta‐analysis

et al. 2021

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Background Postoperative air leaks are a common complication after lung surgery. They are associated with prolonged hospital stay, increased postoperative pain and treatment costs. The treatment of prolonged air leaks remains controversial. Several treatments have been proposed including different types of sealants, chemical pleurodesis, or early surgical intervention. The aim of this review was to analyze the impact of autologous blood pleurodesis in a systematic way. Methods A systematic review of the literature was conducted until July 2020. Studies with more than five adult patients undergoing lung resections were included. Studies in patients receiving blood pleurodesis for pneumothorax were excluded. The search strategy included proper combinations of the MeSH terms “air leak”, “blood transfusion” and “lung surgery”. Results Ten studies with a total of 198 patients were included in the analysis. The pooled success rate for sealing the air leak within 48 h of the blood pleurodesis was 83.7% (95% CI: 75.7; 90.3). The pooled incidence of the post‐interventional empyema was 1.5%, with a pooled incidence of post‐interventional fever of 8.6%. Conclusions Current evidence supports the idea that autologous blood pleurodesis leads to a faster healing of postoperative air leaks than conservative treatment. The complication rate is very low. Formal recommendations on how to perform the procedure are not possible with the current evidence. A randomized controlled trial in the modern era is necessary to confirm the benefits.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

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Autologous blood pleurodesis for the treatment of postoperative air leaks. A systematic review and meta‐analysis

et al. 2021

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“…Nevertheless, the local control in our patient cohort appears to be very promising. Regarding SBRT in MPM patients there is only one case report about a patient receiving Cyberknife treatment (70 Gy/5 fx) for a focal paravertebral recurrence after MCR in MPM who remained disease-free at 40 months (19). Additionally, two case series exist about patients receiving palliative stereotactic IMRT by Munter et al, but not for an oligoprogressive setting as in our cohort (20, 21).…”

Section: Discussionmentioning

confidence: 99%

Stereotactic Body Radiation Therapy (SBRT) as Salvage Therapy for Oligorecurrent Pleural Mesothelioma After Multi-Modality Therapy

et al. 2019

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Introduction: Therapy options for patients with oligoprogressive malignant pleural mesothelioma (MPM) are limited. Stereotactic Body Radiotherapy (SBRT) may be a promising therapeutic option, as it delivers a localized ablative dose of radiation and therefore balances efficacy and treatment related toxicities. The intent of this retrospective analysis was to evaluate the feasibility of SBRT for limited pleural recurrences.Methods and Materials: This retrospective single-institution study is based on the 21 consecutive patients treated with hypofractionated radiotherapy for oligoprogressive MPM. Clinical and radiological data was collected at regular follow-up visits including toxicity, local control and survival.Results: At primary diagnosis, 57% of the patients presented with stage III disease. Initial treatment of MPM consisted of induction chemotherapy (n = 12) prior to a macroscopic complete resection (n = 18). Three patients received additional intracavitary chemotherapy and another three patients were treated with chemotherapy alone without another treatment at the time of first diagnosis. A total of 50 lesions in recurrent MPM were treated with SBRT. The median number of radiotherapy fractions was 5 (range 3–20) with a median dose per fraction of 5 Gy (range 2.5–12.5 Gy). The median total treatment dose was 30 Gy (20–50 Gy) with a median prescription isodose line (IDL) of 65% (65–100%). Median follow-up of all patients from diagnosis was 28 months (range 7–152 months). Analyzing all lesions separately, the 12-months-local control from SBRT was 73.5%. The median progression free survival (PFS) after SBRT was 6 months (range 0–21 months) and the median OS from first first SBRT was 29 months (range 0–61 months). Only one patients experienced above Grade 3 toxicities.Conclusion: This analysis demonstrates the feasibility of a SBRT approach for oligorecurrent MPM. SBRT was well-tolerated even after multiple repetitions and local control was high with a promising median OS.

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“…Lang-Lazdunski et al [6] also recommended cyberKnife radiosurgery for focal paravertebral recurrence after radical pleurectomy/decortication in MPM. While cytoreductive surgery in the early Stage provides a good prognostic factor, the general consensus among surgeons is that there are other unknown prognostic markers.…”

Section: Discussionmentioning

confidence: 99%

A case of surgically treated bilateral metachronous malignant pleural mesothelioma

Bedirhan

Cansever

Yöney

et al. 2019

Turk Gogus Kalp Dama

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Bu yazıda, hastanemize sağ plevral efüzyon ve sağ taraflı göğüs ağrısı ile kabul edilen ve torasentez ve plevral biyopsi ile malign plevral mezotelyoma tanısı konulan 59 yaşında bir erkek hasta sunuldu. Hastanın ameliyat edilebilir olduğunun belirlenmesini takiben, sağ parietal plörektomi + perikardiyal rezeksiyon + diyafragma rezeksiyonu uygulandı ve adjuvan tedavi olarak dört siklus sisplatin ve pemetreksed kombinasyonu eklendi. Hasta üç buçuk yıl boyunca herhangi bir problem olmaksızın takip edildi. Bu dönemde, sol taraflı göğüs ağrısı ve sol taraflı efüzyon fark edildi. Torasentez ve plevral biyopside tümör negatif idi. Sonra, evre 1a malign plevral mezotelyoma ile sonuçlanan video yardımlı torakoskopik cerrahi gerçekleştirildi. Torakoskopik parietal plörektomi başarıyla uygulandı. Adjuvan tedavi olarak dört siklus pemetreksed tek ajan terapisi uygulandı. Hasta tümörsüzken birinci ameliyatın 57. ve ikincisinin 21. ayında kronik obstrüktif akciğer hastalığı ve kalp yetmezliği nedeniyle öldü. Bildiğimiz kadarıyla, bu olgu literatürdeki ilk ameliyat edilmiş iki taraflı metakron primer malign plevral mezotelyomadır. Anah tar söz cük ler: Asbestozis; malign plevral mezotelyoma; plevra tümörleri; cerrahi.

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Cyberknife radiosurgery for focal paravertebral recurrence after radical pleurectomy/decortication in malignant pleural mesothelioma

Cited by 6 publications

References 9 publications

Autologous blood pleurodesis for the treatment of postoperative air leaks. A systematic review and meta‐analysis

Autologous blood pleurodesis for the treatment of postoperative air leaks. A systematic review and meta‐analysis

Stereotactic Body Radiation Therapy (SBRT) as Salvage Therapy for Oligorecurrent Pleural Mesothelioma After Multi-Modality Therapy

A case of surgically treated bilateral metachronous malignant pleural mesothelioma

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