Tuberc Respir Dis.  2015 Jan;78(1):36-40. 10.4046/trd.2015.78.1.36.

A Case of Advanced Malignant Pleural Mesothelioma Treatment with Chemotherapy and Photodynamic Therapy

• Ryu JW
• Kim YS

• KMID: 2114648
• DOI: http://doi.org/10.4046/trd.2015.78.1.36

Abstract

Malignant pleural mesothelioma (MPM) is an aggressive, treatment-resistant, and generally fatal disease. A 68-year-old male who was diagnosed with MPM at another hospital came to our hospital with dyspnea. We advised him to take combination chemotherapy but he refused to take the treatment. That was because he had already received chemotherapy with supportive care at another hospital but his condition worsened. Thus, we recommended photodynamic therapy (PDT) to deal with the dyspnea and MPM. After PDT, the dyspnea improved and the patient then decided to take the combination chemotherapy. Our patient received chemotherapy using pemetrexed/cisplatin. Afterwards, he received a single PDT treatment and then later took chemotherapy using gemcitabine/cisplatin. The patient showed a survival time of 27 months, which is longer than median survival time in advanced MPM patients. Further research and clinical trials are needed to demonstrate any synergistic effect between the combination chemotherapy and PDT.

Keyword

Mesothelioma, Malignant; Pleura; Photodynamic Therapy; Chemotherapy

MeSH Terms

Aged
Drug Therapy*
Drug Therapy, Combination
Dyspnea
Humans
Male
Mesothelioma*
Photochemotherapy*
Pleura

Figure

• 

  Figure 1 The initial chest radiograph at our hospital shows a huge mass with multiple pleural nodules and pleural effusion in the right hemithorax.

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  Figure 2 (A) The initial chest computed tomography (CT) scans at another hospital shows a pleural mass without pleural effusion in the right upper chest. (B) After 4 months, the initial chest CT scans at our hospital shows a mass of about 11.5×16 cm with pleural effusion and disseminated pleura metastasis in the right hemithorax. Direct invasion to paratracheal lymph node, right paraaortic nodal station, and pleura in the back of the right lower lobe was observed.

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  Figure 3 (A) The pleural mass. (B) Photodynamic therapy taking place. Laser light is being delivered into the pleural cavity via the optical fiber. (C) Necrotic changes on the pleural surface after photodynamic therapy.

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  Figure 4 (A) This chest radiograph shows the initial findings before photodynamic therapy at our hospital. (B) After 1 week of photodynamic therapy, this chest radiograph shows a slightly decreased extent of consolidation in the right lower chest.

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