title: Survival of mesothelioma in a palliative medical care unit in egypt.
abstract: BACKGROUND
  This study was to evaluate the survival of patients with pleural and intraperitoneal malignant mesothelioma and to investigate the efficacy of chemotherapy (CT) as well as radiotherapy (RTH) and surgery compared to best supportive care (BSC).
  
  
  METHODS
  Forty patients with malignant mesothelioma (38 with pleural and 2 with intraperitoneal) were enrolled. Twenty seven patients underwent (CT) chemotherapy of which 2 also received (RTH) and surgery was only for biopsy in 15/40. Combination chemotherapy included cisplatin-gemcitabine, cisplatin-navelbine and cisplatin (or carboplatin) with premetrexed. Thirteen patients received only best supportive care.
  
  
  RESULTS
  A total of 12 (30%) patients were male, and 28 (70%) female. Median age was 54.0 years and the male/female ratio was 1/2.33 (P=0.210). Residential exposure played a major role in two regions, Helwan and Shoubra, in 20% and 15%, respectively. Overall mean survival time was 13.9±2.29 months. That for patients who had received best supportive care was 7.57±1.85 months, for chemotherapy was 16.5±3.20 months, and multimodality treatment regimen 27±21.0 months (P=0.028). Kaplan-Meier survival did not significantly vary for sex, residence and the pathological types epithelial, mixed and sarcomatous. The median survival for performance status and treatment modalities was significant (P=0.001 and 0.028). Best supportive care using opioids with a mean dose of 147.1 mg (range 0-1680) of morphine sulphate produced good subjective response and reasonable quality of life but did not affect survival.
  
  
  CONCLUSIONS
  We conclude that CT prolongs survival compared to BSC in patients with malignant mesothelioma. Moreover, using escalating doses of opioids provides good pain relief and subjective responses.
authors.affiliation: Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Kasr El-Aini School of Medicine, Cairo University. daliaomard@yahoo.com
authors.forename: Noha
authors.initials: N
authors.lastname: Ibrahim
authors.forename: Enas
authors.initials: E
authors.lastname: Abou-Elela
authors.forename: Dalia
authors.initials: D
authors.lastname: Darwish
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D004534:Egypt; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D010146:Pain / Q000188:drug therapy; D010166:Palliative Care; D010997:Pleural Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D011788:Quality of Life; D012189:Retrospective Studies; D013534:Survival; D015996:Survival Rate; D014747:Vinblastine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077235:Vinorelbine; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D014747:Vinblastine; D009020:Morphine; D016190:Carboplatin; D002945:Cisplatin; D000077235:Vinorelbine; D000093542:Gemcitabine