Abstract:
Malignant pleural mesothelioma (MPM) is an aggressive, almost universally fatal cancer with limited therapeutic options. Despite efforts, a real breakthrough in treatment and outcomes has been elusive. Pleural effusion with significant breathlessness and pain is the most typical presentation of individuals with MPM. Although thoracentesis provides relief of breathlessness, most such pleural effusions recur rapidly, and a definitive procedure is often required to prevent a recurrence. Unfortunately, the optimal treatment modality for individuals with recurrent MPM-related effusion is unclear, and considerable variation exists in practice. In addition, non-expandable lung is common in pleural effusions due to MPM and makes effective palliation of symptoms more difficult. This review delves into the latest advances in the available management options (both surgical and non-surgical) for dealing with pleural effusion and non-expandable lung related to MPM. We discuss factors that determine the choice of definitive procedures that need to be tailored to the individual patient.
摘要:
恶性胸膜间皮瘤(MPM)是一种侵袭性、几乎普遍致命的癌症,治疗选择有限。尽管努力,在治疗和结果方面的真正突破一直难以捉摸.伴有明显呼吸困难和疼痛的胸腔积液是MPM患者最典型的表现。虽然胸腔穿刺术可以缓解呼吸困难,大多数这样的胸腔积液复发迅速,通常需要明确的程序来防止复发。不幸的是,复发性MPM相关性积液患者的最佳治疗方式尚不清楚,在实践中存在相当大的差异。此外,肺不张在MPM引起的胸腔积液中很常见,这使有效缓解症状更加困难。这篇综述探讨了处理与MPM相关的胸腔积液和不可扩张肺的可用管理选择(手术和非手术)的最新进展。我们讨论了决定选择需要针对个体患者量身定制的最终程序的因素。