title: Nonselective transarterial chemoperfusion: a palliative treatment for malignant pleural mesothelioma.
abstract: OBJECTIVE
  To evaluate tumor response by means of volumetric assessment, survival, and changes in patient symptoms after the treatment of unresectable and/or recurrent pleural mesothelioma by using regional nonselective transarterial chemoperfusion as a palliative treatment option.
  
  
  METHODS
  This retrospective study was approved by the hospital ethical committee, and all patients signed an informed consent prior to treatment. Thirty-nine patients (mean age, 64.0 years; 10 women and 29 men) with unresectable pleural mesothelioma were treated with repetitive transarterial chemoperfusion between March 2007 and March 2010, with a mean of 2.9 sessions per patient at 4-week intervals. Transarterial chemoperfusion was performed by using mitomycin C, cisplatin, and gemcitabine. Computed tomography findings and patient symptoms were evaluated. Tumor response was evaluated by using Response Evaluation Criteria in Solid Tumors guidelines, and survival was assessed with the Kaplan-Meier method. The change in volume for the partial-response group was tested by using the Wilcoxon signed-rank test.
  
  
  RESULTS
  In 36% of treated tumors (14 of 39), partial response was achieved, and tumor volume decreased from a mean value ± standard deviation of 839.6 mL ± 590.3 (range, 3.9-1972.2 mL) to 137 mL ± 399.8 (range, 0.88-1131.4; P = .00012). In 49% of tumors (19 of 39), stable disease was noted. In 15% of tumors (six of 39), progressive disease was seen. Mean specific growth rate of the tumor was 0.00158% per day. The mean survival time was 14.2 months (range, 2.1-33.1 months) from the start of treatment. For patients with tumors that responded to treatment, mean survival time was 15 months (range, 4.5-33.1 months). Mean time to disease progression was 2.6 months for all tumors, 1.5 months for stable disease, and 1.3 months for progressive disease.
  
  
  CONCLUSIONS
  Transarterial chemoperfusion may have the potential to yield positive results and response in the treatment of recurrent and/or unresectable pleural mesothelioma. © RSNA, 2012.
authors.affiliation: Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany. T.Vogl@em.uni-frankfurt.de
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Vogl
authors.forename: Sebastian
authors.initials: S
authors.lastname: Lindemayr
authors.forename: Nagy N N
authors.initials: NN
authors.lastname: Naguib
authors.forename: Jessen
authors.initials: J
authors.lastname: Gurung
authors.forename: Nour-Eldin A
authors.initials: NE
authors.lastname: Nour-Eldin
authors.forename: Stephan
authors.initials: S
authors.lastname: Zangos
authors.forename: Emmanuel C
authors.initials: EC
authors.lastname: Mbalisike
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018450:Disease Progression; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy*; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D010147:Pain Measurement; D010166:Palliative Care; D010997:Pleural Neoplasms / Q000188:drug therapy*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D016685:Mitomycin; D002945:Cisplatin; D000093542:Gemcitabine