Cytoreductive surgery (CRS) combined with hyperthermic intrathoracic chemoperfusion (HITOC) is a promising treatment strategy for pleural mesothelioma (PM). The aim of this study was to evaluate the impacts of this multimodal approach in combination with systemic treatment on disease-free survival (DFS) and overall survival (OS). In this retrospective multicenter study, clinical data from patients after CRS and HITOC for PM at four high-volume thoracic surgery departments in Germany were analyzed. A total of 260 patients with MPM (220 epithelioid, 40 non-epithelioid) underwent CRS and HITOC as part of a multimodal treatment approach. HITOC was administered with cisplatin alone (58.5%) or cisplatin and doxorubicin (41.5%). In addition, 52.1% of patients received neoadjuvant and/or adjuvant chemotherapy. The median follow-up was 48 months (IQR = 38 to 58 months). In-hospital mortality was 3.5%. Both the resection status (macroscopic complete vs. incomplete resection) and histologic subtype (epithelioid vs. non-epithelioid) had significant impacts on DFS and OS. In addition, adjuvant chemotherapy (neoadjuvant/adjuvant) significantly increased DFS (p= 0.003). CRS and HITOC within a multimodal treatment approach had positive impacts on the survival of patients with epithelioid PM after macroscopic complete resection. The addition of chemotherapy significantly prolonged the time to tumor recurrence or progression.
细胞减灭术联合胸腔热灌注化疗是治疗胸膜间皮瘤的一种前景广阔的治疗策略。本研究旨在评估这种多模式治疗方法联合全身治疗对无病生存期和总生存期的影响。在这项回顾性多中心研究中，我们分析了德国四家高手术量胸外科中心接受细胞减灭术和胸腔热灌注化疗治疗的胸膜间皮瘤患者的临床数据。共有260例恶性胸膜间皮瘤患者（220例上皮型，40例非上皮型）接受了作为多模式治疗方案组成部分的细胞减灭术和胸腔热灌注化疗。胸腔热灌注化疗采用单药顺铂（58.5%）或顺铂联合多柔比星（41.5%）方案。此外，52.1%的患者接受了新辅助和/或辅助化疗。中位随访时间为48个月（四分位距38-58个月）。住院死亡率为3.5%。切除状态（肉眼完全切除与不完全切除）和组织学亚型（上皮型与非上皮型）均对无病生存期和总生存期有显著影响。此外，辅助化疗（新辅助/辅助）显著提高了无病生存期（p=0.003）。在多模式治疗方案中，细胞减灭术联合胸腔热灌注化疗对肉眼完全切除后的上皮型胸膜间皮瘤患者的生存具有积极影响。联合化疗能显著延长肿瘤复发或进展的时间。
肿瘤(癌症)患者之家