title: Complete response and long-term survival in malignant pleural mesothelioma: case report.
abstract: Malignant pleural mesothelioma is a rare tumour. A three-modal strategy, comprising of surgery, radiotherapy and chemotherapy has been shown to be essential for appropriate management. Current literature evidences the importance of radiation therapy in the adjuvant setting for local control of the disease, as part of a multidisciplinary treatment, with increment of progression-free survival rate, but also of disease-free survival.
  
  
  METHODS
  At the beginning of 2007, a 26-year-old Peruvian woman was admitted to the hospital referring breathlessness and other non-specific symptoms such as fever and weight loss. After the diagnosis of pleural mesothelioma by thoracoscopic talc insufflation, combined with pleural biopsy, and total body computed tomographic scan, the patient underwent two cycles of neoadjuvant chemotherapy with pemetrexed (500 mg/m(2)) and cisplatin (75 mg/m(2)), followed by an extra-pleural pneumonectomy. After 6 months, the patient was treated with three-dimensional external beam radiation therapy to the left hemithorax. Computed tomographic scans, performed after the ending of the radiotherapy, integrated with positron-emission tomography, were all negative for neoplastic pathology. The patient remains in good health and free from recurrence at four years.
  
  
  CONCLUSIONS
  This clinical case shows a disease-free survival interval of 4 years for malignant pleural mesothelioma. A good staging system and a combined treatment, involving surgery, neoadjuvant chemotherapy and adjuvant radiation therapy, represent a useful strategy not only to contain local disease progression, but even to increase disease-free survival in pleural mesothelioma.
authors.affiliation: Department of Radiation Oncology, Polyclinic Umberto I, Sapienza University of Rome, Rome, Italy. silvia_takanen@hotmail.com
authors.forename: Silvia
authors.initials: S
authors.lastname: Takanen
authors.forename: Blerina
authors.initials: B
authors.lastname: Resuli
authors.forename: Vanessa
authors.initials: V
authors.lastname: Graziano
authors.forename: Alessandro
authors.initials: A
authors.lastname: Parisi
authors.forename: Roberto
authors.initials: R
authors.lastname: Lisi
authors.forename: Nicola
authors.initials: N
authors.lastname: Raffetto
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Tombolini
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008654:Mesothelioma / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D000068437:Pemetrexed; D010997:Pleural Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D049268:Positron-Emission Tomography; D016896:Treatment Outcome
chemical_list: D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine; D002945:Cisplatin