A review of the treatment of diffuse malignant pleural mesothelioma.

When the disease is diagnosed early, pleurectomy or intrapleural inoculation of colloidal radioactive compounds may be effective. However, most mesotheliomas are already diffuse by the time they are diagnosed; and no treatment has been shown to be effective. Metastatic involvement of the chest wall results from any surgical procedure; however, pain may be controlled by pleurectomy and/or external-beam radiotherapy. Of the chemotherapeutic agents tested, doxorubicin appears to be the most promising. Large, cooperative, controlled trials are needed to evaluate the usefulness of one or a combination of the treatment methods described.