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恶性胸膜间皮瘤的诱导化疗与术后辅助治疗对比

Induction chemotherapy vs post-operative adjuvant therapy for malignant pleural mesothelioma.

作者信息

Marulli Giuseppe, Faccioli Eleonora, Bellini Alice, Mammana Marco, Rea Federico

机构信息

a Thoracic Surgery Unit, Department of Cardiologic, Thoracic and Vascular Sciences , University of Padova , Padova , Italy.

出版信息

Expert Rev Respir Med. 2017 Aug;11(8):649-660. doi: 10.1080/17476348.2017.1338951. Epub 2017 Jun 12.

Abstract

Malignant pleural mesothelioma (MPM) is an aggressive neoplasia. Multidisciplinary treatments, including the association of induction and/or adjuvant therapeutic regimens with surgery, have been reported to give encouraging results. Current therapeutic options are not well standardized yet, especially regarding the best association between surgery and medical treatments. The present review aims to assess safety, efficacy and outcomes of different therapies for MPM. Areas covered: This article focuses on the multimodality treatment of mesothelioma. A systematic review was performed by using electronic databases to identify studies that considered induction and adjuvant approaches in MPM therapy in a multidisciplinary setting, including surgery. Endpoints included overall survival, disease free survival, disease recurrence, and complications. Expert commentary: This systematic review offers a comprehensive view of current multidisciplinary therapeutic strategies for MPM, suggesting that multimodality therapy offers acceptable outcomes with better results reported for trimodality approaches. Individualization of care for each patient is fundamental in choosing the most appropriate treatment. The growing complexity of treatment protocols mandates that MPM patients be referred to specialized Centers, in which every component of the interdisciplinary team can provide the necessary expertise and quality of care.

摘要

恶性胸膜间皮瘤(MPM)是一种侵袭性肿瘤。据报道,包括诱导和/或辅助治疗方案与手术相结合的多学科治疗取得了令人鼓舞的结果。目前的治疗选择尚未得到很好的标准化,尤其是在手术与药物治疗的最佳联合方面。本综述旨在评估MPM不同治疗方法的安全性、疗效和结果。涵盖领域:本文重点关注间皮瘤的多模式治疗。通过使用电子数据库进行系统综述,以识别在多学科背景下(包括手术)考虑MPM治疗中诱导和辅助方法的研究。终点包括总生存期、无病生存期、疾病复发和并发症。专家评论:该系统综述全面介绍了当前MPM的多学科治疗策略,表明多模式治疗可提供可接受的结果,三联疗法报告的结果更好。为每位患者提供个性化护理是选择最合适治疗方法的基础。治疗方案日益复杂,要求MPM患者转诊至专门中心,跨学科团队的每个组成部分都能在其中提供必要的专业知识和护理质量。

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