Intervention Review

Radiotherapy for malignant pleural mesothelioma

  1. Evelina Chapman*,
  2. Marcelo García Diéguez

Editorial Group: Cochrane Lung Cancer Group

Published Online: 19 JUL 2006

Assessed as up-to-date: 5 JUN 2009

DOI: 10.1002/14651858.CD003880.pub4


How to Cite

Chapman E, García Diéguez M. Radiotherapy for malignant pleural mesothelioma. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD003880. DOI: 10.1002/14651858.CD003880.pub4.

Author Information

  1. National Academy of Medicine, Epidemiological Research Center, Buenos Aires, Argentina

*Evelina Chapman, Epidemiological Research Center, National Academy of Medicine, Carlos Gardel 768, Dpto 3, Buenos Aires, 4000, Argentina. evelinachap@gmail.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 19 JUL 2006

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Malignant pleural mesothelioma is a relatively uncommon disease, but the incidence is increasing and is expected to peak in many developed countries in the next two decades. The management of patients with malignant mesothelioma is controversial. Very few patients are suitable for any potentially curative treatment and the effectiveness of radical therapy with surgery, radiotherapy and/or chemotherapy in curing patients or prolonging survival is uncertain. The role of radiotherapy is controversial although it has been used as part of multimodal therapy. The present review will try to clarify these uncertainties.

Objectives

To assess the effectiveness and safety of radiotherapy on patients with malignant pleural mesothelioma in any stage of the disease.

Search methods

We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2008), MEDLINE (1966 to January 2009) and EMBASE (1974 to January 2009). We performed handsearches aimed at the identification of evidence by reviewing journals not indexed in databases, conference proceedings and/or scientific meetings.

Selection criteria

We included all randomised controlled clinical trials using radiotherapy for malignant pleural mesothelioma in any stage, alone or combined with other therapies in patients of either sex and any age. We excluded studies without a control group.

Data collection and analysis

No studies fulfilled the inclusion criteria.

Main results

We found no reports of randomised comparisons of radiotherapy alone or combined for patients with malignant pleural mesothelioma.

Authors' conclusions

As radiotherapy has never been compared to chemotherapy or surgery or to best supportive care (as part of combination therapy) in a prospective, randomised trial, there are no data to support one or the other treatment as a better option for patients with malignant pleural mesothelioma. There is a need for multicentre controlled randomised trials assessing the role of radiotherapy in the radical treatment of malignant pleural mesothelioma. The studies should be limited to patients with malignant pleural mesothelioma, classified by stage, cytology and type of radiotherapy. The type of radiotherapy should be defined in advance and variables of radiotherapy dose definition and delivery should be carefully controlled.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

There is no evidence that radiotherapy could help to cure or to prolong the survival of patients with malignant pleural mesothelioma

The incidence of malignant pleural mesothelioma is increasing and is expected to peak in many developed countries in the next two decades. In 80% of the patients with malignant pleural mesothelioma there is a clear history of occupational or domestic exposure to asbestos. Very few patients are suitable for any potentially curative treatment and the effectiveness of radical therapy with surgery, radiotherapy and/or chemotherapy in curing patients or prolonging survival is uncertain. The role of radiotherapy is controversial. It has been used as a component of multimodal therapy (plus chemotherapy and/or surgery). The reviewers have not found any reports of randomised controlled trials (RCTs) that show that radiotherapy is an effective option for malignant pleural mesothelioma. There is a need for multicentre experimental studies assessing the role of radiotherapy in this disease.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

惡性肋膜間皮細胞瘤之放射治療

惡性肋膜間皮細胞瘤相對來說是不常見的疾病,但是在發展中國家的發生率在過去二十年中持續的增加,治療方式也是有爭議。只有非常少數的病人適合給予任何可能痊癒的治療。根本治療方法包括手術加上放射線治療或化學治療在治癒或延長存活的效力仍未確定。雖然放射線治療是多種形式治療的一部份,但是角色仍未確定。目前的回顧試著去釐清這些不確定性。

目標

評估放射線治療在任何期別的惡性肋膜間皮細胞瘤病人身上的效力和安全性

搜尋策略

同時使用的電子以及人工搜尋。電子資料庫,包括Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE,用來搜尋所有的臨床隨機對照試驗。人工搜尋則是用來辨識來自於不是資料庫,期刊或學術會議紀錄的證據

選擇標準

所有的隨機對照試驗是比較單獨的放射線治療或合併其他治療在任何期別,性別和年紀的惡性肋膜間皮細胞瘤。沒有對照組的研究是被排除的。

資料收集與分析

沒有任何的研究是符合收案條件

主要結論

到目前為止,我們沒有發現任何隨機對照試驗比較單獨的放射線治療或合併其他治療在惡性肋膜間皮細胞瘤的研究

作者結論

因為放射線治療從未曾和化學治療、手術或良好的支持性照護在前瞻性的隨機試驗中做比較,沒有任何的資料支持任何一種治療在惡性肋膜間皮細胞瘤是較好的選擇,所以需要多中心的隨機對照試驗來評估放射線治療在惡性間皮細胞瘤根本治療的角色。這些研究的病人必須是惡性間皮細胞瘤並且根據期別、細胞學以及放射線治療方式來分類。放射線治療的劑量以及給予方式也必須確定。

翻譯人

沒有證據支持放射線治療對於惡性肋膜間皮細胞瘤的治癒或者延長存活有幫助。在發展中國家,惡性肋膜間皮細胞瘤的發生率在過去二十年中持續的增加,80%的病人都有明確的職業或家庭的石綿暴露史,只有非常少數的病人適合給予任何可能痊癒的治療。根本治療方法包括手術加上放射線治療或化學治療在治癒或延長存活的效力仍未確定。雖然放射線治療是多種形式治療的一部份,但是角色仍未確定。到目前為止,沒有任何一個隨機控制試驗能支持放射線治療是治療惡性肋膜間皮細胞瘤較佳的選擇,所以需要多中心的隨機對照試驗來評估放射線治療在惡性間皮細胞瘤治療的角色。

總結

本摘要由臺北榮民總醫院葉尚倫翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。