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Treatment of malignant pleural mesothelioma Cvitanović, Slavica; Kanceljak-Macan, Božica; Kotarac, Slava; Matanić, Dubravka; Vuković, Jonatan & Kardum, Goran Abstract Aim: To evaluate the effect of chemotherapy in treatment of patients with malignant pleural mesothelioma. Methods: The effectiveness of chemotherapy was evaluated in 29 patients with malignant pleural mesothelioma (MPM). The patients were treated in Clinical Hospital Split, University Hospital for Lung Diseases, between the years 2002-2005. 24/29 patients (82.7 %) were occupationally exposed to asbestos. Chemotherapy was applied after determination of MPM subtype by pathohystological immunohystochemistry. Results: Epitheloid mesothelioma was determined in 23/29 (79.3 %) patients. Results of treatment were analyzed separately in 6 patients treated with gemcitabine/cisplatine (PG protocol) in first line therapy, in 9 patients treated with epirubicine/mitomycine (EM protocol) in first line therapy, and in 14 patients who refused chemotherapy and were on supportive therapy. In accordance with WHO recommendations the evaluation of chemotherapy effectiveness by response rate (RR) and mean survival curve (MS) was done. RR was 33% in both groups: those on PG and EM protocol, but MS was significantly better in patients treated with EM protocol in the first line chemotherapy comparing to PG protocol and supportive care. Conclusions: The EM protocol has better MS results then PG protocol treatment. However, this study have confirmed the chemo resistance of the tumor, low response rate to the chemotherapy (only 10-30 %), without significant influence to MS. Keywords asbestos, chemotherapy, malignant pleural mesothelioma

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Liječenje malignog mezotelioma poplućnice Cvitanović, Slavica; Kanceljak-Macan, Božica; Kotarac, Slava; Matanić, Dubravka; Vuković, Jonatan & Kardum, Goran Cilj: Procijeniti učinkovitost kemoterapije u liječenju malignog mezotelioma poplućnice. Metode: U ovom radu retrospektivno je analizirana učinkovitost kemoterapije malignog mezotelioma poplućnice (MPM) u 29 oboljelih, liječenih u Klinici za plućne bolesti KB Split od 2002. – 2005. godine. Većina oboljelih 24/29, (82,7 %) bili su profesionalno izloženi azbestu. Liječenje je provedeno nakon što je patohistološkom imunohistokemijskom metodom dokazan podtip MPM. Rezultati: U 23/29 (79,3 %) oboljelih utvrđen je epiteloidni tip mezotelioma. Analizirani su rezultati liječenja u tri skupine oboljelih: 1. gemcitabin /cisplatin u prvoj liniji (PG protokol) u 6 oboljelih, 2. epirubicin / mitomicin u prvoj liniji (EM protokol) u 9 oboljelih, 3. suportivna terapija u 14 oboljelih koji su odbili kemoterapiju. Efikasnost terapije ocijenjena je definiranom stopom odgovora – response rate (RR) i izračunom krivulje preživljenja – mean survival (MS) prema preporukama WHO. Utvrđeni RR 33 % nije se razlikovao između skupina liječenih PG i EM protokolom, ali je MS bolesnika liječenih EM protokolom u prvoj liniji znatno bolje od onih koji su liječeni PG protokolom ili suportivnom terapijom. Zaključak: Rezultati liječenja pokazuju da se EM protokolom postiže značajno bolje MS, nego PG protokolom. No, rezultati studije se slažu s rezultatima iz literature koji kazuju da je tumor kemorezistentan, te da je stopa tumorskog odgovora niska, a iznosi 10-30 % i bez značajnog utjecaja na MS. azbest, kemoterapija, maligni mezoteliom poplućnice

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