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Improving the outcome in malignant pleural mesothelioma: nonaggressive or aggressive approach?


Stahel, R A; Weder, W (2009). Improving the outcome in malignant pleural mesothelioma: nonaggressive or aggressive approach? Current Opinion in Oncology, 21(2):124-130.

Abstract

PURPOSE OF REVIEW: The treatment of malignant pleural mesothelioma continues to be a clinical challenge. The question, however, is no longer whether to provide active treatment or not, but how aggressive the treatment should be in view of the limited life expectancy of patients with this disease. RECENT FINDINGS: With platin and pemetrexed-based combination chemotherapy having become the preferred systemic therapy, the major questions now evolve around the identification of a suitable second line therapy and the quest for innovative new approaches. Surgical interventions from pleurectomy and decortication to extrapleural pneumonectomy have increasingly come of use in specialized centres. With neoadjuvant chemotherapy and extrapleural pneumonectomy median survival times of almost 2 years have been reported. Studies on high-dose hemithoracic radiotherapy after extrapleural pneumonectomy suggested a beneficial effect on local recurrence. However, both extrapleural pneumonectomy and high-dose hemithoracic radiotherapy are associated with potential treatment-related mortality and morbidity and cannot yet be recommended outside specialized centres. SUMMARY: More than ever, the diagnosis and treatment of patients with malignant pleural mesothelioma mandate a multidisciplinary approach.

PURPOSE OF REVIEW: The treatment of malignant pleural mesothelioma continues to be a clinical challenge. The question, however, is no longer whether to provide active treatment or not, but how aggressive the treatment should be in view of the limited life expectancy of patients with this disease. RECENT FINDINGS: With platin and pemetrexed-based combination chemotherapy having become the preferred systemic therapy, the major questions now evolve around the identification of a suitable second line therapy and the quest for innovative new approaches. Surgical interventions from pleurectomy and decortication to extrapleural pneumonectomy have increasingly come of use in specialized centres. With neoadjuvant chemotherapy and extrapleural pneumonectomy median survival times of almost 2 years have been reported. Studies on high-dose hemithoracic radiotherapy after extrapleural pneumonectomy suggested a beneficial effect on local recurrence. However, both extrapleural pneumonectomy and high-dose hemithoracic radiotherapy are associated with potential treatment-related mortality and morbidity and cannot yet be recommended outside specialized centres. SUMMARY: More than ever, the diagnosis and treatment of patients with malignant pleural mesothelioma mandate a multidisciplinary approach.

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11 citations in Web of Science®
11 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Oncology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Thoracic Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2009
Deposited On:27 Jul 2009 14:32
Last Modified:05 Apr 2016 13:18
Publisher:Lippincott Wiliams & Wilkins
ISSN:1040-8746
Publisher DOI:10.1097/CCO.0b013e328324bc30
PubMed ID:19532013
Permanent URL: http://doi.org/10.5167/uzh-19931

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