腔内治疗在恶性胸膜间皮瘤治疗中的作用。
The role of intracavitary therapies in the treatment of malignant pleural mesothelioma.
作者信息
Bertoglio Pietro, Aprile Vittorio, Ambrogi Marcello Carlo, Mussi Alfredo, Lucchi Marco
机构信息
Division of Thoracic Surgery, Sacro Cuore Don Calabria Research Hospital and Cancer Care Centre, Negrar, Verona, Italy.
Division of Thoracic Surgery, Department of Surgical, Medical and Molecular pathology and Critical Area, University Hospital of Pisa, via Paradisa 2 56100 Pisa (PI), Italy.
出版信息
J Thorac Dis. 2018 Jan;10(Suppl 2):S293-S297. doi: 10.21037/jtd.2017.10.165.
Surgery is one of the steps of multimodality approach for the treatment of MPM. Due to anatomical features, microscopically radical (R0) resection is never possible and a Macroscopic Complete Resection (R1) is considered the target for mesothelioma surgeons. Recently, intracavitary therapies have been described with the aim of extending the loco-regional effect of surgery. Different agents might be administered intrapleurally: chemotherapy drugs are the most widely used, but also photodynamic therapy (PDT) showed to lead to satisfactory long-term outcomes; furthermore, immunotherapies and gene therapies have been also reported. Despite promising results, no high-quality evidences are currently available and controlled randomized trials are required to establish the exact role of intracavitary therapies and to standardize the technique.
手术是多模式治疗恶性胸膜间皮瘤（MPM）的步骤之一。由于解剖学特征，微观上的根治性（R0）切除是不可能的，而宏观完全切除（R1）被认为是间皮瘤外科医生的目标。最近，已经描述了腔内治疗，目的是扩大手术的局部区域效果。不同的药物可以胸膜内给药：化疗药物是使用最广泛的，但光动力疗法（PDT）也显示出能带来令人满意的长期效果；此外，免疫疗法和基因疗法也有报道。尽管有令人鼓舞的结果，但目前尚无高质量的证据，需要进行对照随机试验来确定腔内治疗的确切作用并规范该技术。
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