Two Cases of Malignant Pleural Mesothelioma Treated With Chemotherapy Plus Concurrent High-dose Hemithoracic Radiation After Extrapleural Pneumonectomy

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Background. Despite radical multimodality therapy to improve local control, the large majority of patients with malignant pleural mesothelioma die of locoregional failure. We report two cases of malignant pleural mesothelioma treated with chemotherapy plus concurrent high-dose hemithoracic radiation after extrapleural pneumonectomy. Cases. 50-and 60-year-old man were diagnosed as having epithelial cell type of right-sided malignant pleural mesothelioma, clinical stage I. They were treated with chemoradiotherapy consisting of cisplatin (6mg/m2 every day), vindesine (3mg/m2 once weekly), and concurrent hemithoracic radiation (50 Gy) two months after extrapleural pneumonectomy. Two patients developed only treatment-related toxicities of grade 3 or greater neutropenia during the chemoradiation phase and no discontinuation of treatment. They had positive resection margins, however, no local failure inside of the radiation field. The one is alive with recurrent disease outside the radiation field for twenty two months since the operation. The other died due to bacterial pneumonia ten months after the operation. Conclusion. Extrapleu-ral pneumonectomy followed by chemotherapy plus concurrent high-dose hemithoracic radiation is a feasible multimodality therapy to improve local control for patients with malignant pleural mesothelioma.
特定非営利活動法人日本肺癌学会の論文