Tsiouris Athanasios, Walesby Robin K
General and Transplantation Surgery at the Royal Free Hospital, London, UK.
Nat Clin Pract Oncol. 2007 Jun;4(6):344-52. doi: 10.1038/ncponc0839.
Malignant pleural mesothelioma (MPM) is a primary and locally aggressive tumor of the pleura. A well defined causal relationship with asbestos exposure, and an overwhelming media interest in the use of asbestos in industrialized countries after World War II, has produced a high level of awareness of this disease. With a peak incidence of MPM expected in Europe, Australia, and the US within the next 15 years, and the failure of current treatment approaches to offer long-term survival and improve quality of life, new therapeutic regimens are warranted. The effects of surgery in terms of survival and symptomatic relief have yet to be defined because of a lack of randomized trials. The role of radiotherapy in the treatment of MPM remains controversial, as the radiosensitivity of malignant mesothelial cells is modest. MPM response to chemotherapy is comparatively poor. The combination of pemetrexed and cisplatin chemotherapy has achieved the best objective responses. Presently, a multimodal approach is considered to be the cornerstone of treatment of MPM. Important ongoing international and national trials are addressing the roles of chemotherapy (e.g. the EAP and MS01 trial), radical surgery (e.g. the MARS trial) and radiotherapy (e.g. the SAKK group phase III study).
恶性胸膜间皮瘤（MPM）是一种起源于胸膜的原发性局部侵袭性肿瘤。由于其与石棉暴露之间存在明确的因果关系，且二战后工业化国家媒体对石棉使用的高度关注，人们对这种疾病的认识程度很高。预计在未来15年内，欧洲、澳大利亚和美国MPM的发病率将达到峰值，而目前的治疗方法无法实现长期生存和改善生活质量，因此需要新的治疗方案。由于缺乏随机试验，手术在生存和症状缓解方面的效果尚未明确。放疗在MPM治疗中的作用仍存在争议，因为恶性间皮细胞的放射敏感性一般。MPM对化疗的反应相对较差。培美曲塞和顺铂联合化疗取得了最佳的客观缓解。目前，多模式治疗方法被认为是MPM治疗的基石。正在进行的重要国际和国内试验正在探讨化疗（如EAP和MS01试验）、根治性手术（如MARS试验）和放疗（如SAKK组III期研究）的作用。
