Radical pleurectomy and intraoperative photodynamic therapy for malignant pleural mesothelioma.
Radical pleurectomy and intraoperative photodynamic therapy for malignant pleural mesothelioma.
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对恶性胸膜间皮瘤的自由基胸膜切除术和术中光动力疗法。
DOI：
10.1016/j.athoracsur.2012.02.009
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发表时间：
2012-05
影响因子：
4.6
通讯作者：
Cengel, Keith
中科院分区：
文献类型：
--
作者：
Friedberg, Joseph S.;Culligan, Melissa J.;Mick, Rosemarie;Stevenson, James;Hahn, Stephen M.;Sterman, Daniel;Punekar, Salman;Glatstein, Eli;Cengel, Keith
根治性胸膜切除术（RP）间皮瘤通常被认为是技术上不可行或手术仅限于病人谁不会容忍肺切除术。本研究的目的是回顾我们使用RP和术中光动力疗法（PDT）治疗间皮瘤的经验。38例患者（42-81岁）接受了RP-PDT。35/38例（92%）患者还接受了全身治疗。采用标准统计技术进行分析。37/38例（97%）患者患有III/IV期（AJCC）癌症，7/38例（18%）患者患有非上皮亚型。37/38例（97%）患者实现了肉眼完全切除。有1例术后死亡（卒中）。在中位随访34.4个月时，所有38例患者的中位生存期为31.7个月，31/38（82%）上皮患者为41.2个月，7/38（18%）非上皮患者为6.8个月。中位无进展生存期分别为9.6、15.1和4.8个月。20/31（64%）例N2疾病上皮患者的中位无进展生存期和无进展生存期分别为31.7和15.1个月。在97%的III/IV期患者中，利用肺保留手术可以实现肉眼可见的完全切除。我们用这种方法观察到的上皮亚型患者的生存期异常长，但有趣的是，无进展生存期并非如此。尽管复发，但存活率延长的原因尚不清楚，但可能与肺的保护和/或一些PDT诱导的效应有关。我们的结论是，这种保肺方法的结果是安全的、令人鼓舞的，值得进一步调查。
Radical pleurectomy (RP) for mesothelioma is often considered either technically infeasible or an operation limited to patients who would not tolerate a pneumonectomy. The purpose of this study was to review our experience using RP and intraoperative photodynamic therapy (PDT) for mesothelioma. 38 patients (42–81 years) underwent RP-PDT. 35/38 (92%) patients also received systemic therapy. Standard statistical techniques were employed for analysis. 37/38 (97%) patients had Stage III/IV (AJCC) cancer and 7/38 (18%) patients had nonepithelial subtypes. Macroscopic complete resection was achieved in 37/38 (97%) patients. There was one postoperative mortality (stroke). At a median follow-up of 34.4 months, the median survival was 31.7 months for all 38 patients, 41.2 months for the 31/38 (82%) epithelial patients and 6.8 months for the 7/38 (18%) nonepithelial patients. The median progression free survivals were 9.6, 15.1 and 4.8 months, respectively. The median and progression free survivals for the 20/31 (64%) epithelial patients with N2 disease were 31.7 and 15.1 months, respectively. It was possible to achieve a macroscopic complete resection utilizing lung-sparing surgery in 97% of these stage III/IV patients. The survival we observed with this approach was unusually long for the epithelial subtype patients but, interestingly, the progression free survival was not. The reason for this prolonged survival in spite of recurrence is not clear, but is potentially related to preservation of the lung and/or some PDT-induced effect. We conclude that the results of this lung-sparing approach are safe, encouraging and warrant further investigation.
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影响因子：
5.3
作者：
Boeluekbas, Servet;Manegold, Christian;Schirren, Joachim
通讯作者：
Schirren, Joachim
DOI：
10.1016/j.jtcvs.2007.10.054
发表时间：
2008-03-01
影响因子：
6
作者：
Flores, Raja M.;Pass, Harvey I.;Rusch, Valerie W.
通讯作者：
Rusch, Valerie W.
影响因子：
4.6
作者：
Friedberg, Joseph S.;Mick, Rosemarie;Cengel, Keith
通讯作者：
Cengel, Keith
影响因子：
3.9
作者：
Sugarbaker, David J;Wolf, Andrea S
通讯作者：
Wolf, Andrea S
DOI：
10.1053/j.semtcvs.2009.07.001
发表时间：
2009-06-01
影响因子：
2.5
作者：
Friedberg, Joseph S.
通讯作者：
Friedberg, Joseph S.