Comparison of supportive treatment and pleurodesis in patients with malignant pleural mesothelioma

Öz

Objectives: Malignant Pleural Mesothelioma (MPM) is a poor prognosis cancer that affects pleura. This study was designed for examination of the differences between MPM patients which who were received only supportive treatment and supportive treatment plus pleurodesis. Materials and methods: The files of 96 MPM patients were analyzed retrospectively who were followed up in Dicle University Medical Faculty Hospital. Age, gender, exposure of asbestos, diagnostic methods, histopathological types and treatment regimens were recorded. Results: The mean age of 96 MPM patients were 60.4 ± 12.6 years. The sixty-three (65.6%) patients were male and 33 (34.4%) were female. A total 75 (78.1%) patients have environmental asbestos exposure and mean environmental asbestos exposure time was 33 years. The epithelial type of pleural mesothelioma was determined in 63 patients. Pleural fluid cytology was positive in 30 patients. The most detected symptom was dyspnea which was determined in 91 cases. Thirty patients were taken only supportive treatment and 66 were taken supportive treatment plus pleurodesis. The median survival time was 10 months in the total of the two groups. Median survival was 10.7 months, in the group that treated with pleurodesis and 9.1 months in the group that not treated with pleurodesis. However, this difference was not statistically significant (p = 0.35). Conclusions: Malignant pleural mesothelioma is an aggressive form of cancer which is resistant to many therapeutic options. Progressive dyspnea is primary symptom in these patients and often depends on the pleural fluid. Pleurodesis is an option to control the fluid. However, there is not any contribution on survival, alone. Extensive investigations are needed on this topic.

Anahtar Kelimeler

• Support treatment, mesothelioma, pleurodesis

Malign plevral mezotelyoma hastalarında destek tedavisi ve plöredezin karşılaştırılması

Öz

Amaç: Malign Plevral Mezotelyoma (MPM) plevrayı tutan ve kötü prognozlu bir kanser türüdür. Bu çalışma, sadece destek tedavisi alan ve destek tedavisi ile birlikte plöredez uygulanan MPM hastaları arasındaki farkları inceleme amaçlı planlandı. Gereç ve yöntem: Dicle Üniversitesi Tıp Fakültesi Hastanesinde takip edilen 96 MPM hastasının dosyası retrospektif olarak incelendi. Yaş, cinsiyet, asbest teması, tanı yöntemleri, histopatolojik tip ve tedavi rejimleri verileri kaydedildi. Bulgular: Toplam 96 MPM hastasının yaş ortalaması 60,4 ± 12,6 yıldı. Altmış üç hasta erkek (% 65,6) ve 33 hasta kadındı (% 34,4). Toplam 75 (% 78,1) hastada çevresel asbest teması vardı ve ortalama çevresel asbest teması süresi 33 yıldı. Toplam 63 (% 65,6) hastada epitelyal tip MPM saptandı. Plevral sıvı sitolojisi 30 hastada pozitif saptandı. En sık saptanan semptom 91 hastada olan nefes darlığıydı. Bu hastalardan otuzu sadece destek tedavisi almışken 66 hastaya destek tedavisi ile birlikte plöredez uygulanmıştı. Her iki grubun toplamında ortalama sağkalım süresi yaklaşık 10 aydı. Plöredez uygulanan grupta ortalama sağkalım 10,7 ay iken uygulanmayan grupta ise 9,1 ay idi. Fakat bu fark istatistiksel olarak anlamlı bulunmadı (p= 0,35). Sonuç: Malign Plevral Mezotelyoma, bir çok tedavi seçeneğine dirençli olan ve agresif seyreden bir kanser türüdür. İlerleyici nefes darlığı, bu hastalarda öncelikli yakınmadır ve çoğunlukla plevral sıvıya bağlıdır. Plöredez sıvıyı kontrol altına almada bir seçenektir. Fakat tek başına sağkalıma katkısı görülmemektedir. Bu konuyla ilgili geniş serili çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Destek tedavisi, mezotelyoma, plöredez

Kaynakça

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