May 30th, 2006. The role of radiation therapy in thoracic tumors
Radiation therapy is the definitive local treatment for patients who have surgically resectable but medically inoperable non-small cell lung cancer (NSCLC) and is an important part of the multimodality regimen for unresectable NSCLC, limited-stage small cell lung cancer, esophageal cancer, invasive thymoma, and mesothelioma. This article briefly reviews indications, evidence, and new advances in radiation therapy for the treatment of these thoracic tumors.
May 30th, 2006. My approach to the diagnosis of mesothelial lesions
The separation of reactive mesothelial proliferations from malignant mesothelioma on small biopsy can be quite difficult, as distinguishing features, such as stromal invasion, often cannot be adequately assessed. In adequately sampled lesions, however, the distinction between malignant mesothelioma, benign mesothelial proliferations and other tumours can be achieved in most cases by using a carefully intergrated approach that incorporates clinical and radiographic data, immunohistochemical studies and, in selected cases, histochemical and ultrastructural techniques.
May 26th, 2006. Diachronic study of pleural plaques in rural population with environmental exposure to asbestos
Conclusions: Radiological appearance of pleural plaques and respiratory function of people previously exposed to asbestos environmental pollution worsens over the years. Prevalence of mesothelioma was found to be higher than expected.
May 26th, 2006. WNT signaling in malignant mesothelioma
The importance of these pathways in tumorigenesis is emphasized by the many cancers which show aberrations in Wnt signaling. In this review we examine the current evidence for activation of Wnt signaling and the abnormal expression of specific molecules in malignant mesothelioma.
May 24th, 2006. Management of malignant pleural mesothelioma
There have been few randomized controlled trials regarding treatment options, although these have increased in recent years, and results are eagerly awaited. This article summarizes important advances in the management of mesothelioma, especially diagnostic and therapeutic aspects.
Conclusions: The results confirm the high information value of systematic collection of incidental cases in the population, which is feasible thanks to the disease register, and the significant role of the local Occupational Health Services in demonstrating past asbestos exposure.
May 23rd, 2006. Cluster cases of malignant pleural mesothelioma in an oil factory
Results: Following examination of the archives of the Local Health Unit and inspection of the plant, an environmental asbestos contamination (pipes and boilers) was found. The 3 cases were defined as occupational disease and the required legal procedures were initiated. This underlines the importance of close cooperation with Local Health Units of occupational medicine and the Regional Mesothelioma Registry in the study and acknowledgment of cases which would otherwise not have been recognized, with consequent loss of precious information.
May 23rd, 2006. Ten Cases of Feline Mesothelioma: an Immunohistochemical and Ultrastructural Study
Electron microscopy, performed in four cases, revealed microvillar structures, desmosomes and intracytoplasmic lumina, confirming its value as a diagnostic tool. The study showed that mesothelial marker antibodies commonly used in human patients can be used for the diagnosis of feline mesothelioma, preferably as a panel of antibodies rather than only one.
May 23rd, 2006. Management of malignant mesothelioma by decortication and adjunct phototherapy
The survival curve was compared to that of 17 matched patients treated by decortication alone. Median survival increased from 250 to 440 days in the combined treatment group.
Conclusions: This model mimics the progression of human malignant mesothelioma and it is easy to perform and reproducible; therefore it can be useful to study human MPM biology and evaluate the efficacy of novel therapies.
May 17th, 2006. The risk of secondary malignancies over 30 years after the treatment of non-Hodgkin lymphoma
Conclusions: The overall risk of secondary malignancies was increased for NHL survivors and varied according to age at NHL diagnosis, gender, and treatment.
May 17th, 2006. A case of abdominal mesothelioma diagnosed
Because of tumour-associated inflammatory activity, indium-III leucocyte scintigraphy enabled us to establish a diagnosis. To our knowledge, the use of indium-III leucocyte scintigraphy in peritoneal mesothelioma has not been reported previously.
May 15th, 2006. Genetic Predisposition to Fiber Carcinogenesis Causes a Mesothelioma Epidemic in Turkey
In summary, pedigree and mineralogical studies indicate that the malignant mesothelioma epidemic is caused by erionite exposure in genetically predisposed individuals. This is the first time that genetics is shown to influence mineral fiber carcinogenesis.
May 12th, 2006. Metabolic genotypes as modulators of asbestos-related pleural malignant mesothelioma risk: A comparison of Finnish and Italian populations
Combination of NAT2 fast acetylator and GSTM1 null genotype posed a significantly increased risk of MM in the Italian, but not in the Finnish study. The opposite results obtained in Finland and Italy may be ascribed to random chance, but a role may be hypothesized for the fact that different types of asbestos have been used in the two countries.
May 12th, 2006. A novel radiation therapy technique for malignant pleural mesothelioma combining electrons with intensity-modulated photons
Conclusions: This study showed that IMRT or IMRT+e is a viable treatment modality for MPM patients. Both plans can provide excellent target coverage and normal tissue sparing, but with the addition of electron beams, the critical structures can be further spared. Additional refining of the electron contribution is expected to further reduce radiation-induced morbidity.
May 12th, 2006. Foxp3 Expressing CD4+ CD25+ and CD8+CD28− T Regulatory Cells in the Peripheral Blood of Patients with Lung Cancer and Pleural Mesothelioma
However, the lack of correlation between cancer stage and the number or the function of peripheral Treg cells in LC patients refuted the hypothesis that these cells are involved in tumor spreading. A possible involvement of the peripheral Treg cell pool in cancer development and/or in inducing systemic immunosuppression in LC patients can be hypothesized.
May 12th, 2006. Update of mortality and cancer incidence in the Australian petroleum industry cohort
Conclusions: Most cases of mesothelioma are probably related to past exposure to asbestos in refineries. No occupational cause has been identified for the excess of melanoma, or prostatic or bladder cancer. The possibility of a causal relationship between cancer of the kidney and hydrocarbon exposure warrants further study. It is uncertain whether benzene exposures, particularly past levels of exposure, have been high enough to cause ANLL.
May 11th, 2006. Synchronous pulmonary carcinoma and pleural diffuse malignant mesothelioma
These synchronous neoplasms occur in patients who have risk factors for both neoplasms independently. Length of survival following diagnosis is bleak.
May 11th, 2006. Incidence and Survival of Mesothelioma in Osaka, Japan
Conclusions: Incidence of mesothelioma has increased remarkably in Osaka, Japan, during past few decades. Geographical variations in the incidence were also suggested. Five-year survival of the patients was very poor.
May 10th, 2006. Imaging before and after multimodal treatment for malignant pleural mesothelioma
Conclusions: CT, PET and CT-PET are indicated for diagnosis and, above all, for staging of MPM, in the selection of patients who might benefit from surgery after neoadjuvant therapy and also in identifying small recurrences and/or remote metastases. Being highly specific, PET is essential in the follow-up of patients undergoing chemoradiotherapy alone and/or surgery. Each imaging modality has its advantages and limitations, but their combined use is crucial in determining the most appropriate treatment options for patients with MPM.
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