Is Radiotherapy Useful for Treating Pain in Mesothelioma?
Is Radiotherapy Useful for Treating Pain in Mesothelioma?
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DOI：
10.1097/jto.0000000000000499
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发表时间：
2015-06-01
影响因子：
20.4
通讯作者：
Laird, Barry J.
中科院分区：
文献类型：
--
作者：
MacLeod, Nicholas;Chalmers, Anthony;Laird, Barry J.
引言：放射治疗通常用于治疗恶性胸膜间皮瘤（MPM）的疼痛，尽管支持这一点的证据有限。本试验的目的是评估放射治疗的作用在MPM.Methods疼痛的治疗：多中心，单臂II期试验进行。符合条件的患者符合以下标准：病理学或放射学诊断为MPM;继发于MPM的疼痛;用于疼痛控制的放射治疗;年龄超过18岁。患者在基线时对疼痛和其他症状进行评估，然后接受20戈伊，每日5次。关键随访点为治疗后5周和12周。主要终点指标是5周时放疗部位疼痛的评估。次要终点包括对生活质量的影响，呼吸困难，疲劳，情绪，毒性和放射学respons.Results：40例患者从英国三个肿瘤中心招募。14名患者在放疗后5周疼痛有临床意义的改善（意向治疗），5名患者完全改善。基于对第5周可评估的30例患者的完整病例分析，第5周时存活的患者中有47%（置信区间为28.3-65.7）的疼痛改善。有没有改善其他关键症状或生活quality.Conclusions：放射治疗疼痛控制MPM是一种有效的治疗比例的患者。未来的研究检查不同的放射治疗方案，以提高反应率是必要的。
Introduction: Radiotherapy is often used to treat pain in malignant pleural mesothelioma (MPM), although there is limited evidence to support this. The aim of this trial was to assess the role of radiotherapy for the treatment of pain in MPM.Methods: A multicentre, single arm phase II trial was conducted. Eligible patients fulfilled the following criteria: pathological or radiological diagnosis of MPM; pain secondary to MPM; radiotherapy indicated for pain control; and more than 18 years of age. Patients had assessments of pain and other symptoms at baseline and then received 20 Gy in five daily fractions. Key follow-up points were 5 and 12 weeks posttreatment. The primary end point measure was assessment of pain at the site of radiotherapy at 5 weeks. Secondary end points included effects on quality of life, breathlessness, fatigue, mood, toxicity, and the radiological response.Results: Forty patients were recruited from three UK oncology centers. Fourteen patients had a clinically meaningful improvement in their pain 5 weeks post radiotherapy (intention to treat), with five patients having a complete improvement. On the basis of a complete case analysis of the 30 patients assessable at week 5, 47% (confidence intervals, 28.3-65.7) of patients alive at week 5 had an improvement in their pain. There was no improvement in other key symptoms or quality of life.Conclusions: Radiotherapy for pain control in MPM is an effective treatment in a proportion of patients. Future studies examining differing radiotherapy regimens with a view to improving response rates are warranted.