Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pleural mesothelioma is a rare but fatal tumour. Numerous attempts to find effective treatment approaches have, in general, been disappointing. To date, the most promising treatment is surgery, or surgery in combination with radio and chemotherapy as a part of a multidisciplinary approach. Preliminary results from clinical trials evaluating intensity modulated radiotherapy are encouraging. Further randomised trials are proposed.
Lung Cancer 2004 Aug
PMID:Radiation therapy of mesothelioma: the Heidelberg experience and future aspects. 1526 41

Malignant pleural mesothelioma has a high morbidity and poor prognosis. Most patients undergo invasive pleural interventions to either facilitate diagnosis and/or alleviate symptoms from malignant pleural effusion. Procedure tract metastasis (PTM) are a well-known complication of pleural procedures in mesothelioma and there has been longstanding debate regarding the role of prophylactic irradiation of tracts in preventing them. This review summarises the existing evidence surrounding this controversial topic. Despite initial discrepancies amongst the results of 3 small, historical trials regarding the efficacy of prophylactic radiotherapy in mesothelioma, two large randomised-control trials have recently provided more clarity. The SMART trial, which randomised over 200 patients, found no benefit of prophylactic radiotherapy in reducing PTM incidence in their primary analysis, with a number needed to treat (NNT) of 25.1 to prevent a single painful PTM. Additionally, there was no benefit in terms of symptomology, health-related quality of life parameters or cost-effectiveness. This is supported by the preliminary results of the Prophylactic Irradiation of Tracts in Patients with Pleural Mesothelioma (PIT) trial, which randomised 375 patients and also found no evidence that prophylactic radiotherapy reduced PTM incidence, although the full results are still awaited. Combined analysis of these trials is planned, which will help clarify whether specific subpopulations may derive benefit from prophylactic radiotherapy, such as patients not receiving chemotherapy. Based on the currently available evidence there is no role for routine delivery of prophylactic radiotherapy to prevent PTM in mesothelioma. Instead holistic and vigilant follow-up of patients is recommended, aiming for adequate palliation of symptoms and support for patients. Should painful nodules develop these can be effectively treated with subsequent palliative radiotherapy. After years of uncertainty and debate, recent international guidelines have consistently advised against the use of prophylactic irradiation of tracts based on contemporary high-quality evidence.
Transl Lung Cancer Res 2018 Oct
PMID:Is there a role for prophylactic radiotherapy to intervention tract sites in patients with malignant pleural mesothelioma? 3045 Feb 97