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Implantation and Monitoring by PET/CT of an Orthotopic Model of Human Pleural Mesothelioma in Athymic Mice
Published on: December 21, 2019
Trimodality therapy for malignant pleural mesothelioma
Gordon Buduhan1, Shekhar Menon, Ralph Aye
1Swedish Cancer Institute, Seattle, Washington, USA.
The Annals of Thoracic Surgery
|August 25, 2009
Summary
This study found that induction chemotherapy followed by extrapleural pneumonectomy (EPP) and adjuvant radiotherapy is a safe treatment for malignant pleural mesothelioma. Intensity-modulated radiotherapy (IMRT) may offer better local control compared to external beam radiotherapy (EBRT).
Area of Science:
- Oncology
- Thoracic Surgery
- Radiation Oncology
Background:
- Malignant pleural mesothelioma is a fatal cancer with controversial optimal treatment sequencing.
- This study evaluates outcomes of a specific multimodal therapy approach.
Purpose of the Study:
- To analyze the outcomes of malignant pleural mesothelioma patients treated with induction chemotherapy, extrapleural pneumonectomy (EPP), and adjuvant radiotherapy.
- To compare the effectiveness of intensity-modulated radiotherapy (IMRT) versus external beam radiotherapy (EBRT) for local control.
Main Methods:
- Retrospective cohort study of 46 mesothelioma patients over 10 years.
- Patients received induction chemotherapy, followed by EPP.
- Adjuvant radiotherapy included external beam radiotherapy (EBRT) for 24 patients and intensity-modulated radiotherapy (IMRT) for 14 patients.
Main Results:
- Operative mortality after EPP was 4.3%. Median overall survival was 24 months.
- Nodal metastases were a significant predictor of survival (HR 3.7).
- The incidence of local recurrence was significantly lower with IMRT (14.3%) compared to EBRT (41.7%).
Conclusions:
- Induction chemotherapy, EPP, and adjuvant radiotherapy are safe for selected mesothelioma patients.
- Adjuvant IMRT appears more effective than EBRT in achieving local tumor control.
- Further research may refine treatment strategies for malignant pleural mesothelioma.
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