Operation and photodynamic therapy for pleural mesothelioma: 6-year follow-up

Moskal, Thomas L.; Dougherty, Thomas J.; Urschel, John D.; Antkowiak, Joseph G.; Régal, Anne-Marie; Driscoll, Deborah L.; Takita, Hiroshi

doi:10.1016/s0003-4975(98)00799-1

Cited by 105 publications

(82 citation statements)

References 21 publications

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“…Studies have reported that the most common and bothersome symptom of patients with mesothelioma is persistent dyspnea resulting from large unilateral pleural effusions [2], and that the conventional treatment options have only a marginal impact on survival and cure [11]. Consequently, pleurodesis has been considered as an alternative treatment option to relieve the symptoms caused by pleural effusion in advanced stages, in which other therapy modalities have limited use [14].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have demonstrated that conventional therapy is not that successful in the management of pleural mesothelioma [10, 11]. Thus, the therapeutic approach to MPM has gone from single-mode to bimodal and, more recently, to multimodal management [3].…”

Section: Introductionmentioning

confidence: 99%

“…In cases with advanced disease, the several therapy modalities applied, however, did not favor survival [3]. Consequently, it has been suggested that new therapy options are needed for the management of MPM in advanced stages [11]. …”

Section: Introductionmentioning

confidence: 99%

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Comparison of the Effectiveness of Some Pleural Sclerosing Agents Used for Control of Effusions in Malignant Pleural Mesothelioma: A Review of 117 Cases

et al. 2000

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Background and Objectives: Management of malignant pleural mesothelioma (MPM) has been an important clinical issue regardless of the treatment modality employed. We aimed to investigate the efficacy of oxytetracycline (OT), Corynebacterium parvum (CP), and nitrogen mustard (NM) in the management of pleural effusion associated with MPM. Methods: One hundred and seventeen patients who had stage-2 MPM or over according to the Butchart staging system and unilateral or bilateral pleural effusion took part in the study. The patients received either OT (35 mg/kg), CP (7 mg), or NM (0.4 mg/kg) through a chest tube for pleurodesis. The association between several clinical parameters and patient survival was also investigated. Results: OT was applied to 59, CP to 29 and NM to 29 cases. A statistical analysis of the results obtained by these agents have demonstrated that OT (30 days, 81%; 90 days, 76.2%) and CP (30 days, 86.2%; 90 days, 79.3%) led to a significantly higher rate of successful pleurodesis as compared to NM (30 days, 48.2%; 90 days, 41.3%; p <0.05). Although the procedure was generally well tolerated by the patients, the NM-treated group experienced significantly more nausea-vomiting (46.1%) and hypotension (35.8%) compared to patients who received OT (nausea-vomiting and hypotension 4.3%; p < 0.001) and CP (nausea-vomiting and hypotension 5.1%; p < 0.001). Furthermore, we found that thrombocytosis, chest pain and weight loss were significantly associated with poor prognosis, whereas epithelial type had a positive effect on survival. Conclusion: These results suggest that OT and CP may be used as effective sclerosing agents for pleurodesis in the control of pleural effusions associated with MPM, without major side effects.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of the Effectiveness of Some Pleural Sclerosing Agents Used for Control of Effusions in Malignant Pleural Mesothelioma: A Review of 117 Cases

et al. 2000

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“…The study concluded that the addition of PDT did not prolong survival or increase local control of MPM; however, the lack of improvement may be attributed to the large number of patients with remaining macroscopic disease, as opposed to residual microscopic disease for which PDT may be more effectively used due to its limited depth of penetration (31). A prospective phase II trial using EPP or PD followed by porfimer sodiummediated PDT occurring from 1991 to 1996 determined that PDT dose was an independent prognostic indicator of survival for involved patients (P<0.009) (35), while a phase I/II dose escalation study of intraoperative m-THPC-PDT following EPP in 2001 determined considerable toxicity associated with PDT and local control in only 50% of studied patients (36). A 2004 study then showed the safety and feasibility of polyhematoporphyrin-mediated PDT for fourteen patients with advanced MPM under hyperbaric oxygen with an improved median survival in the PDT group (P=0.0179) (37).…”

Section: Pdtmentioning

confidence: 99%

Intraoperative adjuncts for malignant pleural mesothelioma

Chan

Sugarbaker

Burt

2017

Transl. Lung Cancer Res.

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Malignant pleural mesothelioma (MPM) is a rapidly fatal disease. Multimodality surgically based therapies may extend survival in select patients, however, local relapse after resection is common.Novel intraoperative adjunctive therapies including heated intraoperative chemotherapy (HIOC), heated intraoperative povidone-iodine (PVP-I), and photodynamic therapy (PDT) target micrometastatic disease and aim to improve local control. This review details the most recent studies and trials of HIOC, heated intraoperative PVP-I, and PDT, this aims to provide an update on some of the most promising intraoperative adjuncts for patients with MPM.Keywords: Malignant pleural mesothelioma (MPM); heated intraoperative chemotherapy (HIOC); heated intraoperative povidone-iodine (PVP-I); photodynamic therapy (PDT)

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“…1 PDT has been approved by the U.S. Food and Drug Administration for the treatment of microinvasive lung cancer, obstructing lung cancer, and obstructing esophageal cancer, as well as for premalignant actinic keratosis and age-related macular degeneration. Studies have shown some efficacy in the treatment of a variety of malignant and premalignant conditions including head and neck cancer, 2,3 lung cancer, [4][5][6] mesothelioma, 7 Barrett's esophagus, 8,9 prostate, 10-12 and brain tumors. 9,[13][14][15] Unlike radiation therapy, PDT uses nonionizing radiation and can be administered repeatedly without cumulative long-term complications since it does not appear to target DNA.…”

Section: Introductionmentioning

confidence: 99%

The role of photodynamic therapy (PDT) physics

2008

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Photodynamic therapy ͑PDT͒ is an emerging treatment modality that employs the photochemical interaction of three components: light, photosensitizer, and oxygen. Tremendous progress has been made in the last 2 decades in new technical development of all components as well as understanding of the biophysical mechanism of PDT. The authors will review the current state of art in PDT research, with an emphasis in PDT physics. They foresee a merge of current separate areas of research in light production and delivery, PDT dosimetry, multimodality imaging, new photosensitizer development, and PDT biology into interdisciplinary combination of two to three areas. Ultimately, they strongly believe that all these categories of research will be linked to develop an integrated model for real-time dosimetry and treatment planning based on biological response.

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Operation and photodynamic therapy for pleural mesothelioma: 6-year follow-up

Cited by 105 publications

References 21 publications

Comparison of the Effectiveness of Some Pleural Sclerosing Agents Used for Control of Effusions in Malignant Pleural Mesothelioma: A Review of 117 Cases

Comparison of the Effectiveness of Some Pleural Sclerosing Agents Used for Control of Effusions in Malignant Pleural Mesothelioma: A Review of 117 Cases

Intraoperative adjuncts for malignant pleural mesothelioma

The role of photodynamic therapy (PDT) physics

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