TITLE

A phase II study of intrapleural immuno-chemotherapy, pleurectomy/decortication, radiotherapy, systemic chemotherapy and long-term sub-cutaneous IL-2 in stage II–III malignant pleural mesothelioma

AUTHOR(S)
Lucchi, Marco; Chella, Antonio; Melfi, Franca; Dini, Paolo; Ambrogi, Marcello; Fino, Leonardo; Fontanini, Gabriella; Mussi, Alfredo
PUB. DATE
March 2007
SOURCE
European Journal of Cardio-Thoracic Surgery;Mar2007, Vol. 31 Issue 3, p529
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Abstract: Objective: From therapeutic nihilism to extremely aggressive management, there is a wide range of possibilities in the treatment of malignant pleural mesothelioma (MPM). Unfortunately, there is little evidence as regards the best treatment to offer to the MPM patients. In 1999, we started a phase II study based on the multimodality treatment of stage II–III MPM, the results of which have been analysed and reported. Methods: From 1999 to 2004, 49 patients with IMIG stage II–III MPM underwent a multimodality treatment including: intrapleural pre-operative interleukin 2 (IL-2, 18×106 UI/day per 3 days), pleurectomy/decortication, intrapleural post-operative epidoxorubicin (25mg/m2 per 3 days), IL-2 (18×106 UI/day per 3 days), adjuvant radiotherapy (30Gy), systemic chemotherapy (cisplatin 80mg/m2 day 1, gemcitabine 1250mg/m2 day 1 and 8 up to 6 courses) and long-term sub-cutaneous IL-2 (3×106 UI/day 3 days per week). Results: There were 41 males and 8 females with a median age of 61 years (range 41–77). All the patients had a diagnosis of MPM by thoracoscopy before inclusion. We did not experience any post-operative mortality. The histology was: 39 epitheliomorf, 6 bifasic and 4 sarcomatous. According to the IMIG the post-operative staging was III in 40 cases and II in 9 cases. With a median follow-up of 59 months (range 14–81) 13 patients are still alive and the median actuarial survival is 26 months (31 and 21 months for stage II and III, respectively). Only the Performance Status at the diagnosis affected survival significantly. Conclusions: The multimodality treatment we adopted for stage II–III MPM was feasible, well tolerated by most of the patients and produced a favourable outcome. New targeted therapies are awaited for further improvements in the treatment of this disease.
ACCESSION #
24141327

 

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