2001 Volume 17 Issue 1 Pages 45-52
Malignant pleural mesothelioma (MPM) is considered to carry dismal prognosis and reported surgical results indicate a median survival time of less than one year for patients with Butchart's stage II or higher. Instead of surgery we performed thermoradiotherapy combined with chemotherapy into the pleural cavity for the treatment of this disease. We encountered 2 stage II cases that achieved a good response and long-term survival. In both cases, hyperthermia was performed to the ipsilateral pleural cavity using 8MHz RF-capacitive heating apparatus for 45-60 minutes per session once a week under the perfusion of CBDCA (450mg/body) for the first case, and CDDP (50mg/body) for the second case. Radiotherapy of 2Gy/fr, 1fr/week was performed to the ipsilateral hemithorax soon before thermochemotherapy. We administered 2 sessions of this treatment for the first case, and 4 sessions for the second case. In both cases, tumor and/or chestwall temperature reached higher than 42 degrees. In both cases, the initial response was PR (Partial response). In the first case intractable pleural effusion disappeared completely and controlled for more than 3 years, though transient hematological grade 4 toxicity was observed. The second case died of local recurrence 27 months following the initial treatment but the first case was surviving with disease at the final follow-up more than 5 years after the initial treatment. This combined modality might be promising without causing any compromise in respiratory function and was able to maintain the quality of life and prolong the life of the patient. Further studies are necessary to optimize the treatment protocol.
