Mesothelioma Research Limitations And Computed Tomography
Another interesting study is called, Effect of drug-light interval on photodynamic
therapy with meta-tetrahydroxyphenylchlorin in malignant Mesothelioma by Hans-Beat Ris, Hans Jrg Altermatt, Bernhard Nachbur, J. Charles M. Stewart, Qiang Wang, Chang Kee Lim, Raymond Bonnett, Ulrich Althaus - International Journal of Cancer Volume 53, Issue 1, pages 141146, 2 January 1993. Here is an excerpt: Abstract - The influence of the time interval (TI) between drug administration and laser activation on selectivity of meta-tetrahydroxy- phenylchlorin(mTHPC)-mediated photodynamic therapy (PDT) for tumour tissue was assessed in BALB/c nude mice bearing human malignant mesothelioma xenografts. Following i.p. administration of 0.3 mg/kg mTHPC, a light dose of 10 J/cm2 and 0.1 W/cm2 was delivered at 650 nm on the tumour and an equal-sized area of the hind leg after 4. I2, 24 and 36 hr and 2,3, 4,5 and 6 days to groups of 6 animals (surface irradiance). Then, 72 hr after light delivery, the depth of necrosis was measured in the tumour and in the skin and underlying muscle of the hind leg. Photosensitized necrosis occurred in normal tissue at TI from 4 hr to 3 days and in the tumour at TI from I2 hr to 4 days. The therapeutic ratio of mTHPC-PDT varied significantly with the time interval between drug administration and laser activation and was greatest at an interval of 3 days. mTHPC concentration was measured in 3 control unirradiated animals at all time points in normal tissues and in tumour tissue, and found to be the same in both tissues. Thus the tissue concentration of mTHPC was of limited use as regards the prediction of photosen-sitizing effects in the tumour model.
One interesting study is called, The Journal of Thoracic and Cardiovascular Surgery - Vol 96, 171-177, - 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association. Here is an excerpt: The role of computed tomography scanning in the initial assessment and the follow-up of malignant pleural Mesothelioma by VW Rusch, JD Godwin and WP Shuman - Department of Surgery, University of Washington, Seattle 98195. Here is an excerpt: Between October 1983 and April 1987, 20 patients with malignant mesothelioma underwent computed tomography scans of the chest and upper abdomen to evaluate the extent of disease before treatment. Twelve of these 20 patients deemed to have some potential for long-term survival had scans performed every 3 months after operation to help detect recurrent disease. Anatomic correlation of computed tomography scan findings was available in all 20 patients. The limitations of computed tomography in initial evaluation were its difficulties in assessing (1) chest wall involvement (nine patients), (2) mediastinal lymph nodes (four patients), (3) transdiaphragmatic extension of tumor (four patients), and (4) peritoneal studding and solid organ metastases less than 2 mm in size (one patient). Computed tomography was helpful in detecting recurrent disease in the 12 patients having long-term follow- up. In six of eight cases with histologically proved recurrence, computed tomography detected tumors from 1 to 8 months before the onset of signs or symptoms. Although computed tomography is known to provide far more information about the extent of disease than plain radiographs, it remains an imperfect tool for the staging of disease in patients with malignant mesothelioma. Despite its limitations, computed tomography is probably the most accurate way to provide follow-up for patients during treatment. Eur J Respir Dis. 1984 Apr;65(3):162-8.
Another interesting study is called, Malignant mesothelioma of the pleura: clinical aspects and symptomatic treatment. By Law MR, Hodson ME, Turner-Warwick M. Here is an excerpt: Abstract - A series of 140 patients with malignant pleural mesothelioma is reported. Clinical presentation was delayed in cases without a large effusion, but there was extensive tumour at presentation, shown by thoracoscopy, thoracotomy or computed tomography, in all patients investigated. Thoracoscopy was a useful diagnostic alternative to thoracotomy. With progression of disease, mesothelial extension was more important than distant metastases, which were usually too small and sparse to produce symptoms. Skin deposits of tumour in sites of previous invasive procedures did not cause pain or other clinical problems, and we consider that diagnostic and therapeutic procedures should not be withheld to avoid them. In the management of recurrent pleural effusions, intrapleural bleomycin, preceded by aspiration and followed by suction, was a useful alternative to surgery. Pneumothorax, spontaneous or iatrogenic, required decortication. Adequate pain relief was difficult; radiotherapy and nerve blocking procedures were not effective and opiates were often necessary.
We all owe a debt of gratitude to these fine researchers. If you found any of these excerpts interesting, please read the studies in their entirety.
by: Mont Wrobleski
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