Cargando…

Induction Chemotherapy Followed by Pleurectomy Decortication and Hyperthermic Intraoperative Chemotherapy (HITHOC) for Early-Stage Epitheliod Malignant Pleural Mesothelioma—A Prospective Report

Malignant pleural mesothelioma (MPM) is an aggressive disease with poor prognosis and the current treatment for early-stage MPM is based on a multimodality therapy regimen involving platinum-based chemotherapy preceding or following surgery. To enhance the cytoreductive role of surgery, some peri- o...

Descripción completa

Detalles Bibliográficos
Autores principales: Bongiolatti, Stefano, Mazzoni, Francesca, Salimbene, Ottavia, Caliman, Enrico, Ammatuna, Carlo, Comin, Camilla E., Antonuzzo, Lorenzo, Voltolini, Luca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658521/
https://www.ncbi.nlm.nih.gov/pubmed/34884251
http://dx.doi.org/10.3390/jcm10235542
_version_ 1784612752475553792
author Bongiolatti, Stefano
Mazzoni, Francesca
Salimbene, Ottavia
Caliman, Enrico
Ammatuna, Carlo
Comin, Camilla E.
Antonuzzo, Lorenzo
Voltolini, Luca
author_facet Bongiolatti, Stefano
Mazzoni, Francesca
Salimbene, Ottavia
Caliman, Enrico
Ammatuna, Carlo
Comin, Camilla E.
Antonuzzo, Lorenzo
Voltolini, Luca
author_sort Bongiolatti, Stefano
collection PubMed
description Malignant pleural mesothelioma (MPM) is an aggressive disease with poor prognosis and the current treatment for early-stage MPM is based on a multimodality therapy regimen involving platinum-based chemotherapy preceding or following surgery. To enhance the cytoreductive role of surgery, some peri- or intra-operative intracavitary treatments have been developed, such as hyperthermic chemotherapy, but long-term results are weak. The aim of this study was to report the post-operative results and mid-term outcomes of our multimodal intention-to-treat pathway, including induction chemotherapy, followed by surgery and Hyperthermic Intraoperative THOracic Chemotherapy (HITHOC) in the treatment of early-stage epithelioid MPM. Since 2017, stage I or II epithelioid MPM patients have been inserted in a surgery-based multimodal approach comprising platinum-based induction chemotherapy, followed by pleurectomy and decortication (P/D) and HITHOC with cisplatin. The Kaplan–Meier method was used to estimate overall survival (OS), disease-free survival (DFS) and progression-free survival (PFS). During the study period, n = 65 patients affected by MPM were evaluated by our institutional Multidisciplinary Tumour Board; n = 12 patients with stage I-II who had no progression after induction chemotherapy underwent P/D and HITHOC. Post-operative mortality was 0, and complications developed in n = 7 (58.3%) patients. The median estimated OS was 31 months with a 1-year and 3-year OS of 100% and 55%, respectively. The median PFS was 26 months with 92% of a 1-year PFS, whereas DFS was 19 months with a 1-year DFS rate of 83%. The multimodal treatment of early-stage epithelioid MPM, including induction chemotherapy followed by P/D and HITHOC, was well tolerated and feasible with promising mid-term oncological results.
format Online
Article
Text
id pubmed-8658521
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-86585212021-12-10 Induction Chemotherapy Followed by Pleurectomy Decortication and Hyperthermic Intraoperative Chemotherapy (HITHOC) for Early-Stage Epitheliod Malignant Pleural Mesothelioma—A Prospective Report Bongiolatti, Stefano Mazzoni, Francesca Salimbene, Ottavia Caliman, Enrico Ammatuna, Carlo Comin, Camilla E. Antonuzzo, Lorenzo Voltolini, Luca J Clin Med Article Malignant pleural mesothelioma (MPM) is an aggressive disease with poor prognosis and the current treatment for early-stage MPM is based on a multimodality therapy regimen involving platinum-based chemotherapy preceding or following surgery. To enhance the cytoreductive role of surgery, some peri- or intra-operative intracavitary treatments have been developed, such as hyperthermic chemotherapy, but long-term results are weak. The aim of this study was to report the post-operative results and mid-term outcomes of our multimodal intention-to-treat pathway, including induction chemotherapy, followed by surgery and Hyperthermic Intraoperative THOracic Chemotherapy (HITHOC) in the treatment of early-stage epithelioid MPM. Since 2017, stage I or II epithelioid MPM patients have been inserted in a surgery-based multimodal approach comprising platinum-based induction chemotherapy, followed by pleurectomy and decortication (P/D) and HITHOC with cisplatin. The Kaplan–Meier method was used to estimate overall survival (OS), disease-free survival (DFS) and progression-free survival (PFS). During the study period, n = 65 patients affected by MPM were evaluated by our institutional Multidisciplinary Tumour Board; n = 12 patients with stage I-II who had no progression after induction chemotherapy underwent P/D and HITHOC. Post-operative mortality was 0, and complications developed in n = 7 (58.3%) patients. The median estimated OS was 31 months with a 1-year and 3-year OS of 100% and 55%, respectively. The median PFS was 26 months with 92% of a 1-year PFS, whereas DFS was 19 months with a 1-year DFS rate of 83%. The multimodal treatment of early-stage epithelioid MPM, including induction chemotherapy followed by P/D and HITHOC, was well tolerated and feasible with promising mid-term oncological results. MDPI 2021-11-26 /pmc/articles/PMC8658521/ /pubmed/34884251 http://dx.doi.org/10.3390/jcm10235542 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bongiolatti, Stefano
Mazzoni, Francesca
Salimbene, Ottavia
Caliman, Enrico
Ammatuna, Carlo
Comin, Camilla E.
Antonuzzo, Lorenzo
Voltolini, Luca
Induction Chemotherapy Followed by Pleurectomy Decortication and Hyperthermic Intraoperative Chemotherapy (HITHOC) for Early-Stage Epitheliod Malignant Pleural Mesothelioma—A Prospective Report
title Induction Chemotherapy Followed by Pleurectomy Decortication and Hyperthermic Intraoperative Chemotherapy (HITHOC) for Early-Stage Epitheliod Malignant Pleural Mesothelioma—A Prospective Report
title_full Induction Chemotherapy Followed by Pleurectomy Decortication and Hyperthermic Intraoperative Chemotherapy (HITHOC) for Early-Stage Epitheliod Malignant Pleural Mesothelioma—A Prospective Report
title_fullStr Induction Chemotherapy Followed by Pleurectomy Decortication and Hyperthermic Intraoperative Chemotherapy (HITHOC) for Early-Stage Epitheliod Malignant Pleural Mesothelioma—A Prospective Report
title_full_unstemmed Induction Chemotherapy Followed by Pleurectomy Decortication and Hyperthermic Intraoperative Chemotherapy (HITHOC) for Early-Stage Epitheliod Malignant Pleural Mesothelioma—A Prospective Report
title_short Induction Chemotherapy Followed by Pleurectomy Decortication and Hyperthermic Intraoperative Chemotherapy (HITHOC) for Early-Stage Epitheliod Malignant Pleural Mesothelioma—A Prospective Report
title_sort induction chemotherapy followed by pleurectomy decortication and hyperthermic intraoperative chemotherapy (hithoc) for early-stage epitheliod malignant pleural mesothelioma—a prospective report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658521/
https://www.ncbi.nlm.nih.gov/pubmed/34884251
http://dx.doi.org/10.3390/jcm10235542
work_keys_str_mv AT bongiolattistefano inductionchemotherapyfollowedbypleurectomydecorticationandhyperthermicintraoperativechemotherapyhithocforearlystageepitheliodmalignantpleuralmesotheliomaaprospectivereport
AT mazzonifrancesca inductionchemotherapyfollowedbypleurectomydecorticationandhyperthermicintraoperativechemotherapyhithocforearlystageepitheliodmalignantpleuralmesotheliomaaprospectivereport
AT salimbeneottavia inductionchemotherapyfollowedbypleurectomydecorticationandhyperthermicintraoperativechemotherapyhithocforearlystageepitheliodmalignantpleuralmesotheliomaaprospectivereport
AT calimanenrico inductionchemotherapyfollowedbypleurectomydecorticationandhyperthermicintraoperativechemotherapyhithocforearlystageepitheliodmalignantpleuralmesotheliomaaprospectivereport
AT ammatunacarlo inductionchemotherapyfollowedbypleurectomydecorticationandhyperthermicintraoperativechemotherapyhithocforearlystageepitheliodmalignantpleuralmesotheliomaaprospectivereport
AT comincamillae inductionchemotherapyfollowedbypleurectomydecorticationandhyperthermicintraoperativechemotherapyhithocforearlystageepitheliodmalignantpleuralmesotheliomaaprospectivereport
AT antonuzzolorenzo inductionchemotherapyfollowedbypleurectomydecorticationandhyperthermicintraoperativechemotherapyhithocforearlystageepitheliodmalignantpleuralmesotheliomaaprospectivereport
AT voltoliniluca inductionchemotherapyfollowedbypleurectomydecorticationandhyperthermicintraoperativechemotherapyhithocforearlystageepitheliodmalignantpleuralmesotheliomaaprospectivereport