Compile Treatment of Mesothelioma

Experience surgical, combination therapy (chemotherapy operation + beam therapy) allowed to develop mesothelioma following recommendations in the oesophagus:

1. Implementation plevropnevmonektomy, the holding through 4-6 weeks to 6 courses of chemotherapy drugs to the appointment of platinum, followed by radiation therapy to a remote area of light and sredostenie. Direct mortality, in different groups of comparison, amounted to 5-22%, median survival - 21 months., 2-5 - Summer survival - 45 and 22% respectively. The factors most favorable prognosis is the type of epithelial tumors, as well as the absence of metastases.

2. Radiation therapy (ODS to 50 Gy.) Leads to a reduction in pain, but no increases life expectancy (increasing doses, as well as a combination of radiation and chemotherapy improves survival is not).

3. The effectiveness of modern chemy preparates with mesothelioma oesophagus rarely exceeds 20%. Marked tumor regression and objective improvement in the application of cisplatin, tsikloplatama, mitomitsina, raltitreksida (tomudeksa), etoposide, karboplatina, ifosfamida, vinorelbina, gemtsitabina (gemzara), pemetrekseda (alimty).

4. Combination chemotherapy to have the schemes: doxorubicin + tsiklofosfan, doxorubicin + ifosfamid, doxorubicin + + cisplatin - mitomitsin S, kampto + + cisplatin mitomitsin S, gemtsitabin + cisplatin (karboplatin), gemtsitabin + alimta, alimta + cisplatin (karboplatin). Last 3 schemes are considered standard treatment mesothelioma oesophagus.

If there effusion in the pleura cavity may vnutriplevralnoe introduction cytostatic drugs or biotherapy with the aim of halting or slowing the accumulation of fluid. To do this, apply cisplatin, bleomitsin, also - interferon and interleukin-2. Possibilities of photodynamic therapy are investigated. In addition, undergoing clinical trials targetnye drugs: avastin, iressa, glivek, thalidomide and others that may increase survival. Among targetnyh drugs should draw attention to inhibitors of vascular endothelial growth factor. It was noted that while mesothelioma oesophagus high level of expression of vascular endothelial growth factor correlates with higher density of capillaries and low survival. In this regard, with mesothelioma studied semaksanib, bevatsizumab (avastin) and thalidomide.

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