Document Detail


Nonselective transarterial chemoperfusion: a palliative treatment for malignant pleural mesothelioma.
MedLine Citation:
PMID:  23151824     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate tumor response by means of volumetric assessment, survival, and changes in patient symptoms after the treatment of unresectable and/or recurrent pleural mesothelioma by using regional nonselective transarterial chemoperfusion as a palliative treatment option.
MATERIALS AND METHODS: This retrospective study was approved by the hospital ethical committee, and all patients signed an informed consent prior to treatment. Thirty-nine patients (mean age, 64.0 years; 10 women and 29 men) with unresectable pleural mesothelioma were treated with repetitive transarterial chemoperfusion between March 2007 and March 2010, with a mean of 2.9 sessions per patient at 4-week intervals. Transarterial chemoperfusion was performed by using mitomycin C, cisplatin, and gemcitabine. Computed tomography findings and patient symptoms were evaluated. Tumor response was evaluated by using Response Evaluation Criteria in Solid Tumors guidelines, and survival was assessed with the Kaplan-Meier method. The change in volume for the partial-response group was tested by using the Wilcoxon signed-rank test.
RESULTS: In 36% of treated tumors (14 of 39), partial response was achieved, and tumor volume decreased from a mean value ± standard deviation of 839.6 mL ± 590.3 (range, 3.9-1972.2 mL) to 137 mL ± 399.8 (range, 0.88-1131.4; P = .00012). In 49% of tumors (19 of 39), stable disease was noted. In 15% of tumors (six of 39), progressive disease was seen. Mean specific growth rate of the tumor was 0.00158% per day. The mean survival time was 14.2 months (range, 2.1-33.1 months) from the start of treatment. For patients with tumors that responded to treatment, mean survival time was 15 months (range, 4.5-33.1 months). Mean time to disease progression was 2.6 months for all tumors, 1.5 months for stable disease, and 1.3 months for progressive disease.
CONCLUSION: Transarterial chemoperfusion may have the potential to yield positive results and response in the treatment of recurrent and/or unresectable pleural mesothelioma. © RSNA, 2012.
Authors:
Thomas J Vogl; Sebastian Lindemayr; Nagy N N Naguib; Jessen Gurung; Nour-Eldin A Nour-Eldin; Stephan Zangos; Emmanuel C Mbalisike
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Publication Detail:
Type:  Journal Article     Date:  2012-11-14
Journal Detail:
Title:  Radiology     Volume:  266     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-30     Completed Date:  2013-04-05     Revised Date:  2013-06-03    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  649-56     Citation Subset:  AIM; IM    
Affiliation:
Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. T.Vogl@em.uni-frankfurt.de
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Cisplatin / administration & dosage
Deoxycytidine / administration & dosage,  analogs & derivatives
Disease Progression
Female
Humans
Infusions, Intra-Arterial
Male
Mesothelioma / drug therapy*
Middle Aged
Mitomycin / administration & dosage
Pain Measurement
Palliative Care*
Pleural Neoplasms / drug therapy*
Questionnaires
Retrospective Studies
Statistics, Nonparametric
Tomography, X-Ray Computed
Treatment Outcome
Chemical
Reg. No./Substance:
15663-27-1/Cisplatin; 50-07-7/Mitomycin; 951-77-9/Deoxycytidine; B76N6SBZ8R/gemcitabine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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