Zervos Michael D, Bizekis Costas, Pass Harvey I
Department of Cardiothoracic Surgery, Division of Thoracic Surgery, New York University School of Medicine, New York, USA.
Curr Opin Pulm Med. 2008 Jul;14(4):303-9. doi: 10.1097/MCP.0b013e328302851d.
Mesothelioma is an aggressive malignancy of the pleura with poor survival. There will be approximately 3000 cases of mesothelioma in the United States annually. Multimodality treatment including neoadjuvant chemotherapy in selected individuals followed by extrapleural pneumonectomy and radiation has been studied in recent trials for its effects on disease free and overall survival This review provides a general overview of malignant mesothelioma with a summary of the most significant articles from within the past year as well as from the past.
Areas of recent interest include the evaluation of osteopontin and mesothelin as new tumor markers for mesothelioma. New phase III trials have been performed to evaluate the use of combined chemotherapy regimens.
Malignant mesothelioma is a very difficult malignancy to treat. Patients with the disease usually have an occupational asbestos exposure, and in some, viral exposure with SV40. There have been many historical treatments including combinations of local control with surgery and radiation as well as attempts to prevent systemic failure with chemotherapy. Novel therapies including intrapleural chemotherapy, photodynamic therapy and hyperthermic perfusion have also been used with some success. Finally there are several attempts at immunomodulating and targeted treatments, which are in phase I/II trials.
间皮瘤是一种侵袭性的胸膜恶性肿瘤，生存率低。美国每年约有3000例间皮瘤病例。近期试验研究了多模式治疗，包括对选定个体进行新辅助化疗，随后行胸膜外全肺切除术和放疗，观察其对无病生存期和总生存期的影响。本综述对恶性间皮瘤进行了概述，并总结了过去一年及以往最重要的文章。
近期关注的领域包括评估骨桥蛋白和间皮素作为间皮瘤新的肿瘤标志物。已开展新的III期试验来评估联合化疗方案的应用。
恶性间皮瘤是一种极难治疗的恶性肿瘤。该病患者通常有职业性石棉接触史，部分患者有SV40病毒接触史。过去有多种治疗方法，包括手术和放疗相结合的局部控制，以及尝试用化疗预防全身衰竭。新型疗法如胸膜内化疗、光动力疗法和热灌注疗法也取得了一定成功。最后，有几种免疫调节和靶向治疗正在进行I/II期试验。
