Raynaud C, Greillier L, Mazieres J, Monnet I, Mastroianni B, Robinet G, Fraboulet G, Dixmier A, Berard H, Lamy R, Letreut J, Lena H, Oliviero G, Botta S, Vergnenegre A, Borget I, Chouaid C
Service de Pneumologie, CH Argenteuil, Argenteuil, France.
Service d'oncologie thoracique, APHM, Marseille, Services de Pneumologie, Marseille, France.
BMC Cancer. 2015 Nov 6;15:857. doi: 10.1186/s12885-015-1881-x.
Malignant pleural mesothelioma (MPM) is a rare disease with poor prognosis in spite of significant improvement in survival, due to new chemotherapy regimens. We describe here patients' profiles and management in daily practice in France.
Observational retrospective study. Data were collected from medical files. All patients with histologically proven MPM diagnosed from January 2005 to December 2008 were included in the participating sites.
Four hundred and six patients were included in 37 sites: mean age 68.9 ± 9.8 years, male predominance (sex ratio 3.27), latency of the disease 45.7 years, epithelioïd type 83 %. Diagnosis was made using thoracoscopy in 80.8 % of patients. Radical surgery was performed in 6.2 % of cases. Chemotherapy was administered to 74.6 % of patients. First line regimens consisted mainly of platinum + pemetrexed (91 %) or pemetrexed alone (7 %). Objective response rate was 17.2 % and another 41.6 % of patients experienced disease stabilization. Half of these patients underwent second line chemotherapy (platinium + pemetrexed 31.6 %, pemetrexed alone 24.6 %), resulting in a 6 % response rate. Third-line chemotherapy (56 patients) yielded disease control in 5.4 % of cases.
The management of MPM in France is usually in accordance with guidelines. Response rates are somewhat lower than those described in clinical trials.
恶性胸膜间皮瘤（MPM）是一种罕见疾病，尽管新的化疗方案显著提高了生存率，但预后仍然较差。我们在此描述法国日常临床实践中患者的情况及治疗方法。
观察性回顾性研究。数据从医疗档案中收集。所有在2005年1月至2008年12月间经组织学确诊为MPM的患者均纳入参与研究的机构。
37个机构共纳入406例患者：平均年龄68.9±9.8岁，男性居多（性别比3.27），疾病潜伏期45.7年，上皮样类型占83%。80.8%的患者通过胸腔镜检查确诊。6.2%的病例进行了根治性手术。74.6%的患者接受了化疗。一线治疗方案主要为铂类+培美曲塞（91%）或单用培美曲塞（7%）。客观缓解率为17.2%，另有41.6%的患者病情稳定。其中一半患者接受了二线化疗（铂类+培美曲塞31.6%，单用培美曲塞24.6%），缓解率为6%。三线化疗（56例患者）的疾病控制率为5.4%。
法国MPM的治疗通常符合指南。缓解率略低于临床试验中描述的缓解率。
