Georgiev Dimcho, Jankova Marija, Krastev Bozhidar, Bilyukova Svetlana
National Oncology Hospital Bulgaria, Radiotherapy, Sofia, Bulgaria.
Universitetska Mnogoprofilna Bolnica za Aktivno Lecenie Sveta Marina EAD, Varna, Bulgaria.
Rep Pract Oncol Radiother. 2024 Oct 3;29(4):509-515. doi: 10.5603/rpor.102614. eCollection 2024.
Although there have been various attempts to find appropriate treatment from best conservative care to multimodal treatments, curative outcomes remain poor.
30 patients with primary and secondary malignant tumors of the pleura were treated in the Radiotherapy Clinic of USHATO during the period from December 2016 to April 2023. Video-assisted thoracoscopic surgery (VATS) and talc pleurodesis was performed in 18 patients (60%). In all patients, radiotherapy for the pleura was performed on a helical tomotherapy machine. In 21 patients (70%), normal fractionated radiotherapy was performed at daily dose of 1.8-2 Gy to total dose of 40 Gy (5 times a week), and in 6 patients (20%), integrated surdosage to 50 Gy was also performed for visible lesions. Hypofractionated radiotherapy (10 fractions of 3 Gy and 4 fractions of 4 Gy) was performed in 3 (10%) patients.
Patients were followed up from 1 month to 57 months (median 14 months) or until death. The observed median survival for all patients was 19.2 months [95% confidence interval (CI): 11.5-26.9] (Fig. 3). The 1-, 2- and 3-year survival rates were 40%, 23% and 7% of patients, respectively. Malignant mesothelioma patients had 1-, 2- and 3-year survival rates of 31%, 10% and 0%, respectively. The 1-, 2-, and 3-year survival rates for patients with secondary malignancies were 54%, 45%, and 18%, respectively.
Our results suggest that helical tomotherapy is a feasible therapeutic option for patients with malignant mesothelioma or malignant secondary pleural involvement with a reasonable toxicity profile relative to other unaffected lung.
尽管人们进行了各种尝试，从最佳保守治疗到多模式治疗来寻找合适的治疗方法，但治疗效果仍然不佳。
2016年12月至2023年4月期间，USHATO放射治疗诊所对30例原发性和继发性胸膜恶性肿瘤患者进行了治疗。18例患者（60%）接受了电视辅助胸腔镜手术（VATS）和滑石粉胸膜固定术。所有患者均在螺旋断层放射治疗机上进行胸膜放疗。21例患者（70%）接受常规分割放疗，每日剂量为1.8 - 2 Gy，总剂量为40 Gy（每周5次），6例患者（20%）对可见病灶还进行了追加剂量至50 Gy的治疗。3例患者（10%）接受了大分割放疗（10次3 Gy和4次4 Gy）。
对患者进行了1个月至57个月（中位时间14个月）的随访或直至死亡。所有患者观察到的中位生存期为19.2个月[95%置信区间（CI）：11.5 - 26.9]（图3）。患者的1年、2年和3年生存率分别为40%、23%和7%。恶性间皮瘤患者的1年、2年和3年生存率分别为31%、10%和0%。继发性恶性肿瘤患者的1年、2年和3年生存率分别为54%、45%和18%。
我们的结果表明，相对于其他未受影响的肺组织，螺旋断层放射治疗对于恶性间皮瘤或继发性胸膜恶性受累患者是一种可行的治疗选择，且毒性特征合理。
