Abstract
We have carried out sequential prospective studies of treatment with surgery alone, chemotherapy, and radiotherapy in malignant mesothelioma of the pleura. The survival of treated patients was contrasted with that of 64 contemporary untreated patients whose clinical condition at presentation was comparable with that of the treated patients. Non-radical surgery alone (28 patients) was of palliative benefit, particularly for the control of recurrent pleural effusions, and may have prolonged survival in one patient with localised malignant mesothelioma. Chemotherapy with doxorubicin, vincristine, and cyclophosphamide (12 patients, with preceding surgery in eight) was without objective benefit. Megavoltage radiotherapy by an off axis beam rotational technique (12 patients, with preceding surgery in eight) abolished pain and dyspnoea and may have prolonged survival in one patient and terminated recurrent pleural effusions in three, but it was of no value in the other patients. There was no significant difference in survival between treatment groups or between treated and untreated patients, and no difference when mesotheliomas of epithelial, sarcomatous, and mixed cell types were examined separately. Treatment of this disease appeared to fail because of the unresponsiveness of the tumour to existing forms of treatment and the advanced stage of the disease at clinical presentation.
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aisner J., Wiernik P. H. Malignant mesothelioma. Current status and future prospects. Chest. 1978 Oct;74(4):438–444. doi: 10.1378/chest.74.4.438. [DOI] [PubMed] [Google Scholar]
- Antman K. H., Blum R. H., Greenberger J. S., Flowerdew G., Skarin A. T., Canellos G. P. Multimodality therapy for malignant mesothelioma based on a study of natural history. Am J Med. 1980 Mar;68(3):356–362. doi: 10.1016/0002-9343(80)90103-5. [DOI] [PubMed] [Google Scholar]
- Borow M., Conston A., Livornese L., Schalet N. Mesothelioma following exposure to asbestos: a review of 72 cases. Chest. 1973 Nov;64(5):641–646. doi: 10.1378/chest.64.5.641. [DOI] [PubMed] [Google Scholar]
- Brenner J., Sordillo P. P., Magill G. B., Golbey R. B. Malignant mesothelioma of the pleura: review of 123 patients. Cancer. 1982 Jun 1;49(11):2431–2435. doi: 10.1002/1097-0142(19820601)49:11<2431::aid-cncr2820491134>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
- Butchart E. G., Ashcroft T., Barnsley W. C., Hoden M. P. The role of surgery in diffuse malignant mesothelioma of the pleura. Semin Oncol. 1981 Sep;8(3):321–328. [PubMed] [Google Scholar]
- Butchart E. G., Ashcroft T., Barnsley W. C., Holden M. P. Pleuropneumonectomy in the management of diffuse malignant mesothelioma of the pleura. Experience with 29 patients. Thorax. 1976 Feb;31(1):15–24. doi: 10.1136/thx.31.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chahinian A. P., Beranek J. T., Suzuki Y., Bekesi J. G., Wisniewski L., Selikoff I. J., Holland J. F. Transplantation of human malignant mesothelioma into nude mice. Cancer Res. 1980 Jan;40(1):181–185. [PubMed] [Google Scholar]
- Chahinian A. P., Holland J. F. Treatment of diffuse malignant mesothelioma: a review. Mt Sinai J Med. 1978 Jan-Feb;45(1):54–67. [PubMed] [Google Scholar]
- Chahinian A. P., Pajak T. F., Holland J. F., Norton L., Ambinder R. M., Mandel E. M. Diffuse malignant mesothelioma. Prospective evaluation of 69 patients. Ann Intern Med. 1982 Jun;96(6 Pt 1):746–755. doi: 10.7326/0003-4819-96-6-746. [DOI] [PubMed] [Google Scholar]
- Dimitrov N. V., Egner J., Balcueva E., Suhrland L. G. High-dose methotrexate with citrovorum factor and vincristine in the treatment of malignant mesothelioma. Cancer. 1982 Oct 1;50(7):1245–1247. doi: 10.1002/1097-0142(19821001)50:7<1245::aid-cncr2820500704>3.0.co;2-h. [DOI] [PubMed] [Google Scholar]
- Dorward A. J., Stack B. H. Diffuse malignant pleural mesothelioma in Glasgow. Br J Dis Chest. 1981 Oct;75(4):397–402. doi: 10.1016/0007-0971(81)90027-9. [DOI] [PubMed] [Google Scholar]
- Elmes P. C., Simpson J. C. The clinical aspects of mesothelioma. Q J Med. 1976 Jul;45(179):427–449. [PubMed] [Google Scholar]
- Eschwege F., Schlienger M. La radiothérapie des mésothéliomes pleuraux malins. A propos de 14 cas irradiés à doses élevées. J Radiol Electrol Med Nucl. 1973 Mar;54(3):255–259. [PubMed] [Google Scholar]
- Gordon W., Jr, Antman K. H., Greenberger J. S., Weichselbaum R. R., Chaffey J. T. Radiation therapy in the management of patients with mesothelioma. Int J Radiat Oncol Biol Phys. 1982 Jan;8(1):19–25. doi: 10.1016/0360-3016(82)90379-0. [DOI] [PubMed] [Google Scholar]
- Jett J. R., Eagan R. T. Chemotherapy for malignant mesothelioma; CAMEO. Am J Clin Oncol. 1982 Aug;5(4):429–431. doi: 10.1097/00000421-198208000-00014. [DOI] [PubMed] [Google Scholar]
- Law M. R., Hodson M. E., Heard B. E. Malignant mesothelioma of the pleura: relation between histological type and clinical behaviour. Thorax. 1982 Nov;37(11):810–815. doi: 10.1136/thx.37.11.810. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Legha S. S., Muggia F. M. Therapeutic approaches in malignant mesothelioma. Cancer Treat Rev. 1977 Mar;4(1):13–23. doi: 10.1016/s0305-7372(77)80016-9. [DOI] [PubMed] [Google Scholar]
- Lewis R. J., Sisler G. E., Mackenzie J. W. Diffuse, mixed malignant pleural mesothelioma. Ann Thorac Surg. 1981 Jan;31(1):53–60. doi: 10.1016/s0003-4975(10)61316-1. [DOI] [PubMed] [Google Scholar]
- Oels H. C., Harrison E. G., Jr, Carr D. T., Bernatz P. E. Diffuse malignant mesothelioma of the pleura: a review of 37 cases. Chest. 1971 Dec;60(6):564–570. doi: 10.1378/chest.60.6.564. [DOI] [PubMed] [Google Scholar]
- Okike N., Bernatz P. E., Woolner L. B. Localized mesothelioma of the pleura: benign and malignant variants. J Thorac Cardiovasc Surg. 1978 Mar;75(3):363–372. [PubMed] [Google Scholar]
- Proimos B. S. Shaping the dose distribution through a tumor model. Radiology. 1969 Jan;92(1):130–135. doi: 10.1148/92.1.130. [DOI] [PubMed] [Google Scholar]
- Ratzer E. R., Pool J. L., Melamed M. R. Pleural mesotheliomas. Clinical experiences with thirty-seven patients. Am J Roentgenol Radium Ther Nucl Med. 1967 Apr;99(4):863–880. [PubMed] [Google Scholar]
- Shearin J. C., Jr, Jackson D. Malignant pleural mesothelioma. Report of 19 cases. J Thorac Cardiovasc Surg. 1976 Apr;71(4):621–627. [PubMed] [Google Scholar]
- Taryle D. A., Lakshminarayan S., Sahn S. A. Pleural mesotheliomas--an analysis of 18 cases and review of the literature. Medicine (Baltimore) 1976 Mar;55(2):153–162. doi: 10.1097/00005792-197603000-00004. [DOI] [PubMed] [Google Scholar]
- Wanebo H. J., Martini N., Melamed M. R., Hilaris B., Beattie E. J., Jr Pleural mesothelioma. Cancer. 1976 Dec;38(6):2481–2488. doi: 10.1002/1097-0142(197612)38:6<2481::aid-cncr2820380637>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
- Whitwell F., Rawcliffe R. M. Diffuse malignant pleural mesothelioma and asbestos exposure. Thorax. 1971 Jan;26(1):6–22. doi: 10.1136/thx.26.1.6. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yap B. S., Benjamin R. S., Burgess M. A., Bodey G. P. The value of adriamycin in the treatment of diffuse malignant pleural mesothelioma. Cancer. 1978 Oct;42(4):1692–1696. doi: 10.1002/1097-0142(197810)42:4<1692::aid-cncr2820420406>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
