Multidisciplinary Palliative Handling Including Isolated Thoracic Perfusion For Progressive Malignant Pleural Mesothelioma: A Retrospective Observational Study.

Journal of B.U.O.N 2019 May-June [Link]

Guadagni S, Masedu F, Zoras O, Zavattieri G, Aigner K, Guadagni V, Fumi L, Clementi M

Abstract

PURPOSE:

To investigate the relative importance of isolated thoracic perfusion (ITP) inwards the multidisciplinary palliative handling of progressive malignant pleural mesothelioma (MPM) patients.

METHODS:

Fifty-two MPM patients alongside progressive illness later systemic chemotherapy alongside cisplatin as well as pemetrexed were submitted to 112 ITP using mitomycin C (25 mg/m2) as well as cisplatin (70 mg/m2) betwixt 2000 as well as 2017. Isolation of the breast was achieved past times insertion of stop-flow balloon catheters via femoral or iliac access. Primary endpoints were adverse events, tumor reply rate, progression-free survival (PFS) as well as overall survival (OS) from initial ITP.

RESULTS:

Median interval-time from MPM diagnosis was nine months. There were no perfusion-related postoperative deaths. The master copy procedure-related complication was persistent leakage of lymphatic fluid from the incision inwards less than 10% of ITP. No severe perfusion-related toxicity was reported, alongside degree iii haematological toxicity as well as platinum-induced neurotoxicity inwards less than 8% of the patients. Following initial ITP, overall tumor reply charge per unit of measurement was 25%, median PFS was vii months (IQR 5-10.5), as well as median OS was sixteen months (IQR 12.5-21). After the concluding ITP, fourteen patients received farther therapies, including targeted therapy alongside cetuximab or bevacizumab. Non-epithelioid histology, phase III, as well as ECOG surgery condition iii pre-ITP were prognostic factors alongside a pregnant influence on OS. Median OS, calculated from the diagnosis of MPM, was 26.5 months (IQR 22.5-28).

CONCLUSIONS:

ITP is safe, tolerable, as well as useful exactly its inclusion inwards the multidisciplinary palliative handling of progressive MPM patients should move investigated inwards a larger multicentre controlled study.



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