Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Jpn J Clin Oncol. 2010 Nov;40(11):1031-6. doi: 10.1093/jjco/hyq083. Epub 2010 Jun 9.
Malignant peritoneal mesothelioma is a rare neoplasm that accounts for ∼1 per 1 million has limited data regarding its frontline therapy. We investigated the treatment outcomes in patients with malignant peritoneal mesothelioma receiving frontline cisplatin-based combination chemotherapy.
We analyzed 14 patients with malignant peritoneal mesothelioma who had been treated by frontline cisplatin-based combination chemotherapy between January 2005 and March 2009. The chemotherapeutic agent added to platinum was gemcitabine in one patient, cyclophosphamide-doxorubicin in three patients and pemetrexed in 10 patients.
The confirmed overall response rate was 35.7% and the disease control rate was 71.4%. In all patients, two complete responses and three partial responses were observed (overall response rate, 35.7%). Stable disease was observed in five patients (35.7%). The median progression free survival was 4.4 months (95% CI, 0.6-9.0) and the median overall survival was 20.1 months (95% CI, 12.7-28.5). There was significant differences for progression free survival (P = 0.031) according to the different chemotherapeutic agents (pemetrexed versus non-pemetrexed agents) added to platinum. Grade 3 or 4 hematologic toxicities included leukopenia in one patient and anemia in three patients. There were no Grade 3 or 4 non-hematologic toxicities or treatment-related deaths.
The platinum-based combination chemotherapy showed moderate activity and a favorable toxicity profile as a frontline treatment for patients with malignant peritoneal mesothelioma. Pemetrexed in combination with platinum showed improved survival outcomes as compared with other combination regimens combined with platinum.
恶性腹膜间皮瘤是一种罕见的肿瘤，每 100 万人中约有 1 例，其一线治疗的数据有限。我们研究了接受一线顺铂为基础的联合化疗的恶性腹膜间皮瘤患者的治疗结果。
我们分析了 2005 年 1 月至 2009 年 3 月期间接受一线顺铂为基础的联合化疗的 14 例恶性腹膜间皮瘤患者。在一名患者中，铂类药物加用的化疗药物是吉西他滨，在三名患者中加用的是环磷酰胺-阿霉素，在 10 名患者中加用的是培美曲塞。
确认的总体缓解率为 35.7%，疾病控制率为 71.4%。在所有患者中，观察到 2 例完全缓解和 3 例部分缓解（总体缓解率为 35.7%）。稳定疾病在 5 例患者中观察到（35.7%）。无进展生存期的中位数为 4.4 个月（95%CI，0.6-9.0），总生存期的中位数为 20.1 个月（95%CI，12.7-28.5）。根据铂类药物联合的不同化疗药物（培美曲塞与非培美曲塞药物），无进展生存期有显著差异（P=0.031）。3 级或 4 级血液学毒性包括 1 例白细胞减少症和 3 例贫血。无 3 级或 4 级非血液学毒性或治疗相关死亡。
顺铂为基础的联合化疗作为恶性腹膜间皮瘤的一线治疗，显示出中等的活性和良好的毒性特征。与其他联合铂类药物的方案相比，培美曲塞联合铂类药物的生存结果有所改善。
