Comprehensive Approach to Peritoneal Mesothelioma Described

Researchers from Columbia University have reported that combined resection, intraperitoneal chemotherapy, and whole abdominal radiation therapy is effective treatment for malignant peritoneal mesothelioma. The details of this study were reported in the February 2008 issue of the American Journal of Clinical Oncology.1

Peritoneal mesothelioma is much less common than pleural mesothelioma, making up less than 20% of all cases. The latency period for abdominal mesothelioma appears to be 20-30 years, which is shorter than the latent period for pleural mesothelioma. Controlled trials of various treatment options are not available for peritoneal mesothelioma due to the relative rarity of this disease. The most common treatment strategy for peritoneal mesothelioma involves a multimodality approach with surgical debulking followed by systemic and/or intraperitoneal chemotherapy. The role of radiation therapy is not well documented.

Researchers involved in the current study treated 27 patients with malignant peritoneal mesothelioma. The regimen reported involved surgical debulking followed by four intraperitoneal courses of cisplatin alternated with four intraperitoneal courses of doxorubicin, four doses of intraperitoneal gamma interferon, a second laparotomy with resection of residual disease plus intraoperative hyperthermic administration of intraperitoneal mitomycin, and cisplatin followed by whole abdominal radiation therapy. These authors reported a median survival of 70 months and a three-year survival of 67%. They also reported that seven patients were alive without evidence of disease at a median of 17 months. These researchers concluded that intensive multimodality therapy was effective for patients with peritoneal mesothelioma.

Comments: This is a relatively large series of patients treated in a uniform manner with relatively good outcomes. The exact contribution of each treatment component is unclear and probably will remain so.

Source - Cancerconsultants.com

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