[Therapy of malignant pleural mesothelioma]

The different therapeutical procedures of malignant pleura-mesothelioma are reviewed. A comparison of studies published so far is difficult or impossible because of the heterogeneity of the clientele and of the protocols. The median survival of untreated patients is 6 months from the date of diagnosis. Radical surgical treatment results in 2-year survival in 10-37%. As these data are not different from those of untreated patients, and additionally this procedure is associated with a perioperative mortality of 6-31%, the indication for radical resection has to be applied very critically. As pleuramesotheliomas are often resistant to radiotherapy, tumour remissions under this treatment are extremely rare. However, this therapy has a palliative analgesic benefit. Chemotherapy with anthracycline containing combinations leads to partial remissions in 20% and a median survival of 11 months. Whether multimodal therapeutical concepts are advantageous or not, will have to be established.