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Titolo:
A phase II trial of surgical resection and adjuvant high-dose hemithoracicradiation for malignant pleural mesothelioma
Autore:
Rusch, VW; Rosenzweig, K; Venkatraman, E; Leon, L; Raben, A; Harrison, L; Bains, MS; Downey, RJ; Ginsberg, RJ;
Indirizzi:
Mem Sloan Kettering Canc Ctr, Dept Surg, Thorac Serv, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, Biostat Serv, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA
Titolo Testata:
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
fascicolo: 4, volume: 122, anno: 2001,
pagine: 788 - 795
SICI:
0022-5223(200110)122:4<788:APITOS>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
CELL LUNG-CANCER; EXTRAPLEURAL PNEUMONECTOMY; POSTOPERATIVE RADIATION; SYSTEMIC CHEMOTHERAPY; MULTIMODALITY THERAPY; TRIMODALITY THERAPY; PROGNOSTIC FACTORS; RANDOMIZED TRIAL; MANAGEMENT; RADIOTHERAPY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Rusch, VW Mem Sloan Kettering Canc Ctr, Dept Surg, Thorac Serv, 1275 York Ave, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr 1275 York Ave New York NY USA 10021
Citazione:
V.W. Rusch et al., "A phase II trial of surgical resection and adjuvant high-dose hemithoracicradiation for malignant pleural mesothelioma", J THOR SURG, 122(4), 2001, pp. 788-795

Abstract

Background: Surgical resection of malignant pleural mesothelioma is reported to have up to an 80% rate of local recurrence. We performed a phase II trial of high-dose hemithoracic radiation after complete resection to determine feasibility and to estimate rates of local recurrence and survival. Methods: Patients were eligible if they had a resectable tumor, as determined by computed tomographic scanning, and adequate cardiopulmonary functionfor extrapleural pneumonectomy or pleurectomy/decortication. After complete resection, patients received hemithoracic radiation (54 Gy) and then werefollowed up with serial computed tomographic scanning. Results: From 1995 to 1998, 88 patients (73 men and 15 women; median age, 62.5 years) were entered into the study. The operations performed included 62 extrapleural pneumonectomies (70%) and 5 pleurectomies/decortications; procedures for exploration only were performed in 21 patients. Seven (7.9%) patients died postoperatively. Adjuvant radiation administered to 57 patients (54 undergoing extrapleural pneumonectomy and 3 undergoing pleurectomy/decortication) at a median dose of 54 Gy was well tolerated (grade 0-2 fatigue, esophagitis), except for one late esophageal fistula. The median survival was 33.8 months for stage I and II tumors but only 10 months for stage III and IV tumors (P =.04). For the patients undergoing extrapleural pneumonectomy, the sites of recurrence were locoregional in 2, locoregional and distant in 5, and distant only in 30. Conclusion: Hemithoracic radiation after complete surgical resection at a dose not previously reported is feasible. This approach dramatically reduces local recurrence and is associated with prolonged survival for early-stage tumors. Stage III disease has a high risk of early distant relapse and should be considered for trials of systemic therapy added to this regimen of resection and radiation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 10:38:19