Department of Radiation Oncology, Hôtel-Dieu de Québec, Centre Hospitalier Universitaire de Québec, 11 Côte du Palais, Québec, QC, Canada.
Radiother Oncol. 2011 Nov;101(2):307-10. doi: 10.1016/j.radonc.2011.08.038. Epub 2011 Oct 6.
To assess the effectiveness of prophylactic irradiation of intervention track (PIT) to prevent tumor seeding in patients with malignant pleural mesothelioma.
A retrospective review was conducted of 171 patients with a histological diagnosis of pleural mesothelioma with some undergoing prophylactic irradiation of intervention sites.
Forty-eight patients (28%) received PIT. A majority of patients were followed until death. Thoracoscopy (88%) was the procedure most often performed. Thirty-three percent of patients received chemotherapy. The median dose of PIT was 21 Gy in 3 fractions with electrons or 6 MV photons. The local progression free survival (LPFS) at the intervention site was significantly higher in the PIT group and was not influenced by chemotherapy. At 6 months, LPFS for the intervention sites was 91% with PIT and 74% without PIT (p=0.002). During the follow-up, 6 patients (13%) in the PIT group had tumor invasion of the subcutaneous tissue compared to 40 patients (33%) in the group without PIT (p=0.008).
This study suggests that PIT in mesothelioma reduces the incidence of procedure tract metastasis. Finally, chemotherapy does not seem to have an influence on the incidence of tract metastasis.
评估预防性照射介入部位（PIT）预防恶性胸膜间皮瘤患者肿瘤种植的效果。
对 171 例经组织学诊断为胸膜间皮瘤且部分患者接受预防性照射介入部位的患者进行回顾性分析。
48 例（28%）患者接受了 PIT。大多数患者随访至死亡。胸腔镜检查（88%）是最常进行的操作。33%的患者接受了化疗。PIT 的中位剂量为 21 Gy，分 3 次用电子束或 6 MV 光子照射。PIT 组的介入部位局部无进展生存率（LPFS）明显更高，且不受化疗影响。在 6 个月时，PIT 组的介入部位 LPFS 为 91%，无 PIT 组为 74%（p=0.002）。在随访期间，PIT 组有 6 例（13%）患者出现皮下组织肿瘤侵犯，而无 PIT 组有 40 例（33%）患者出现（p=0.008）。
本研究表明，PIT 可降低间皮瘤介入部位转移的发生率。最后，化疗似乎对转移发生率没有影响。
