Evidence-based Treatment for a Patient with Malignant Pleural Mesothelioma_Chinese Journal of Evidence-Based Medicine

Authors：

YANG Shukun , YU Qin , WANG Xiaoya , WANG Xinping , CHEN Xiaoxue

Department of Respiratory Medicine, The First Hospital of Lanzhou University, Lanzhou 730000, China;

Corresponding author：

Keywords：

Pleural neoplasm; Malignant pleural mesothelioma; Evidence-based treatment

DOI：

10.7507/1672-2531.20080060

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Objective 　To formulate an evidence-based treatment plan for a patient with malignant pleural mesothelioma.
Methods 　Based on an adequate assessment of the patient’s condition and using the principle of PICO, we searched The Cochrane Library (Issue 1, 2007), PubMed (1996 to February 2007) and EMbase (1974 to February 2007) to identify the best available clinical evidence.
Results 　Five randomized controlled trials, 4 systematic reviews and 1 health economic evaluation were included. According to the current evidence, as well as the patient’s clinical condition and preference, 5 cycles of raltitrexed plus cisplatin were given to the patient along with thoracic drainage and other symptomatic treatment. And the follow-up after 4 months indicated that this treatment plan was appropriate for the patient.
Conclusion 　Evidence-based approaches helped us to prepare the most appropriate chemotherapy plan for this patient and will help improve the therapeutic results for patients with malignant pleural mesothelioma.

Citation： YANG Shukun,YU Qin,WANG Xiaoya,WANG Xinping,CHEN Xiaoxue. Evidence-based Treatment for a Patient with Malignant Pleural Mesothelioma. Chinese Journal of Evidence-Based Medicine, 2008, 08(4): 288-290. doi: 10.7507/1672-2531.20080060 Copy

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2.	Rusch VW. A proposed new international TNM staging system for malignant pleural mesothelioma. Form the International Mesothelioma Interest Group. Lung cancer, 1996, 14(1): 1-12.
3.	Ellis P, Davies AM, Evans WK, et al. The use of chemotherapy in patients with advanced malignant pleural mesothelioma: a systematic review and practice guideline. J Thorac Oncol, 2006, 1(6): 591-601.
4.	Green J, Dundar Y, Dodd S, et al. Pemetrexed disodium in combination with cisplatin versus other cytotoxic agents or supportive care for the treatment of malignant pleural mesothelioma. Cochrane Database of Systematic Reviews. 2007 Issue 1: CD005574.
5.	Fizazi K, Caliandro R, Soulié P, et al. Combination raltitrexed (Tomudex)- oxaliplatin: a step forward in the struggle against mesothelioma? The Institut Gustave Roussy experience with chemotherapy and chemo-immunotherapy in mesothelioma. Eur J Cancer, 2000, 36(12): 1514-1521.
6.	van Meerbeeck JP, Gaafar R, Manegold C, et al. Randomized Phase III Study of Cisplatin With or Without Raltitrexed in Patients With Malignant Pleural Mesothelioma: An Intergroup Study of the European Organisation for Research and Treatment of Cancer Lung Cancer Group and the National Cancer Institute of Canada. J Clin Oncol, 2005, 23(28): 6881-6889.
7.	Bottomley A, Gaafar R, Manegold C, et al. Short-term treatment-related symptoms and quality of life: results from an international randomized phase III study of cisplatin with or without raltitrexed in patients with malignant pleural mesothelioma: an EORTC Lung-Cancer Group and National Cancer Institute, Canada, Intergroup.
8.	Vogelzang NJ, Rusthoven JJ, Symanowski J, et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol, 2003, 21(14): 2636-2644.
9.	O’Brien ME, Watkins D, Ryan C, et al. A randomised trial in malignant mesothelioma (M) of early (E) versus delayed (D) chemotherapy in symptomatically stable patients: the MED trial. Ann Oncol, 2006, 17(2): 270-275.
10.	Muers MF, Rudd RM, O’Brien ME, et al. BTS randomised feasibility study of active symptom control with or without chemotherapy in malignant pleural mesothelioma: ISRCTN 54469112. Thorax, 2004, 59(2): 144-148.
11.	Dundar Y, Bagust A, Dickson R, et al. Pemetrexed disodium for the treatment of malignant pleural mesothelioma: a systematic review and economic evaluation. Health Technol Assess, 2007, 11(1): 1-90.
12.	Travis WD, Brambilla E, Muller-Hermelink HK, et al. World Health Organization classification of tumours. Pathology ＆genetics tumours of the lung, pleural, thymus and heart. Lyon: IARC Press, 2004.

1. Study. J Clin Oncol, 2006, 24(9): 1435-1442.
2. Rusch VW. A proposed new international TNM staging system for malignant pleural mesothelioma. Form the International Mesothelioma Interest Group. Lung cancer, 1996, 14(1): 1-12.
3. Ellis P, Davies AM, Evans WK, et al. The use of chemotherapy in patients with advanced malignant pleural mesothelioma: a systematic review and practice guideline. J Thorac Oncol, 2006, 1(6): 591-601.
4. Green J, Dundar Y, Dodd S, et al. Pemetrexed disodium in combination with cisplatin versus other cytotoxic agents or supportive care for the treatment of malignant pleural mesothelioma. Cochrane Database of Systematic Reviews. 2007 Issue 1: CD005574.
5. Fizazi K, Caliandro R, Soulié P, et al. Combination raltitrexed (Tomudex)- oxaliplatin: a step forward in the struggle against mesothelioma? The Institut Gustave Roussy experience with chemotherapy and chemo-immunotherapy in mesothelioma. Eur J Cancer, 2000, 36(12): 1514-1521.
6. van Meerbeeck JP, Gaafar R, Manegold C, et al. Randomized Phase III Study of Cisplatin With or Without Raltitrexed in Patients With Malignant Pleural Mesothelioma: An Intergroup Study of the European Organisation for Research and Treatment of Cancer Lung Cancer Group and the National Cancer Institute of Canada. J Clin Oncol, 2005, 23(28): 6881-6889.
7. Bottomley A, Gaafar R, Manegold C, et al. Short-term treatment-related symptoms and quality of life: results from an international randomized phase III study of cisplatin with or without raltitrexed in patients with malignant pleural mesothelioma: an EORTC Lung-Cancer Group and National Cancer Institute, Canada, Intergroup.
8. Vogelzang NJ, Rusthoven JJ, Symanowski J, et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol, 2003, 21(14): 2636-2644.
9. O’Brien ME, Watkins D, Ryan C, et al. A randomised trial in malignant mesothelioma (M) of early (E) versus delayed (D) chemotherapy in symptomatically stable patients: the MED trial. Ann Oncol, 2006, 17(2): 270-275.
10. Muers MF, Rudd RM, O’Brien ME, et al. BTS randomised feasibility study of active symptom control with or without chemotherapy in malignant pleural mesothelioma: ISRCTN 54469112. Thorax, 2004, 59(2): 144-148.
11. Dundar Y, Bagust A, Dickson R, et al. Pemetrexed disodium for the treatment of malignant pleural mesothelioma: a systematic review and economic evaluation. Health Technol Assess, 2007, 11(1): 1-90.
12. Travis WD, Brambilla E, Muller-Hermelink HK, et al. World Health Organization classification of tumours. Pathology ＆genetics tumours of the lung, pleural, thymus and heart. Lyon: IARC Press, 2004.

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Evidence-based Treatment for a Patient with Malignant Pleural Mesothelioma

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