Revisión del tratamiento y sobrevida del mesotelioma pleural maligno en el INER

Introduction: It is well known that the malignant pleural mesothelioma (MPM) is refractory to treatment. The treatment only improves the symptoms and prolongs the life. The survival from the diagnosis is 4-16 months, depending on the mesothelioma type. Objective: This is a review of the treatment and the median survival time of patients that were treated at the Institute. Material and methods: A retrospective study in 90 patients who were treated from January 2006 to December 2009 was done. Sex, age, histological type, performance status (ECOG), stage (UICC/AJCC), treatment with Cisplatin/Pemetrexed (C/P). Cisplatin/Vinorelbine (C/V) y Cispatin/Epirubicin (C/E), and median overall survival (SGM) were registered. Results: 84 (93.3%) patients had epithelioid mesothelioma and in 6 (6.6%) sarcomatous or mixed mesothelioma were diagnosed; there were 68 male and 22 female, whose had ECOG 1 in 50 (55.5%) and stage III-IV in 53 (58.8%). At the fi rst phase of treatment, all the patients received 6 cycles of QT and the response was evaluated as: 41 (45.5%) had partial response, 25 (27.6%) had progressive disease and 24 (26.6%) were death. At the second treatment, 46 patients received 4 to 6 cycles of a second line of QT, and 20 patients multimodal treatment: QT, pleuro neumonectomy with mediatinal linfadenectomy and RT in two cases. In this group, one patient had empiema, one bronchial fi stula and one brain matastasis. The index QT/SGM showed: C/P 15.1 months, C/E 14.6 months, C/V 14.3 months. Patients with multimodal treatment had a greater survival: one had 40 months and another one, with 48 months, when the study was fi nished. Conclusions: The chemotherapy with C/V or C/E was similar as C/P. Multimodal chemotherapy resulted in greater survival.