Donahoe Laura L, de Perrot Marc
Division of Thoracic Surgery, Toronto General Hospital, Princess Margaret Cancer Center, University Health Network, Toronto, Canada.
Mesothelioma Program, Division of Thoracic Surgery, University Health Network, Princess Margaret Cancer Center, Toronto General Hospital, 9N-961, Toronto, Ontario M5G 2C4, Canada.
Thorac Surg Clin. 2020 Nov;30(4):461-471. doi: 10.1016/j.thorsurg.2020.08.004. Epub 2020 Sep 12.
Extrapleural pneumonectomy (EPP) is the most extensive form of surgery for mesothelioma, involving en bloc resection of visceral and parietal pleura, lung, diaphragm and pericardium, with reconstruction of the pericardium and diaphragm. It can be performed safely in carefully selected patients. It should be performed in experienced centers as part of a multimodality treatment plan. The SMART approach, with a short course of induction hemithoracic radiation followed by EPP has demonstrated safety and value of hypofractionated hemithoracic radiation combined with complete macroscopic resection. We are conducting a clinical trial with oligofractionated hemithoracic radiation in early-stage mesothelioma.
胸膜外全肺切除术（EPP）是治疗间皮瘤最广泛的手术方式，包括整块切除脏层和壁层胸膜、肺、膈肌和心包，并重建心包和膈肌。在经过精心挑选的患者中可以安全地进行该手术。它应在经验丰富的中心作为多模式治疗计划的一部分来实施。SMART方法，即短疗程诱导性半胸放疗后行EPP，已证明了低分割半胸放疗联合完整的肉眼切除的安全性和价值。我们正在进行一项针对早期间皮瘤的低分割半胸放疗的临床试验。
