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Advances in the diagnosis, treatment and prognosis of malignant pleural mesothelioma.

Authors
  • Zhang, Weiquan
  • Wu, Xinshu
  • Wu, Licun
  • Zhang, Weidong
  • Zhao, Xiaogang
Type
Published Article
Journal
Annals of translational medicine
Publication Date
Aug 01, 2015
Volume
3
Issue
13
Pages
182–182
Identifiers
DOI: 10.3978/j.issn.2305-5839.2015.07.03
PMID: 26366399
Source
Medline
Keywords
License
Unknown

Abstract

Malignant pleural mesothelioma (MPM) is a rare cancer originated from pleural mesothelial cells. MPM has been associated with long-term exposure to asbestos. The prognosis of MPM is poor due to the difficulty of making diagnosis in the early stage, the rapid progression, the high invasiveness and the lack of effective treatment. Although the incidence of MPM is low in China to date, it has a tendency to increase in the coming years. The variety of clinical features may cause the delay of diagnosis and high rate of misdiagnosis. The diagnosis of MPM is based on biopsy of the pleura and immunohistochemistry. As China has become the largest country in the consumption of asbestos, it would give rise to a new surge of MPM in the future. The current treatment of MPM is multimodality therapy including surgery, radiotherapy, chemotherapy and immunotherapy. Two surgical procedures are commonly applied: extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). Three dimensional conformal radiotherapy is used to denote a spectrum of radiation planning and delivery techniques that rely on the 3D imaging to define the tumor. Cisplatin combined with pemetrexed (PEM) is the first-line chemotherapy for MPM. The principal targets in immunotherapy include T cells (Treg), CTLA-4 and PD-1. The diagnosis, treatment and prognosis still remain a major challenge for clinical research and will do so for years to come.

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