Peritoneal mesothelioma drug therapy

Peritoneal mesothelioma (peritoneal mesothelioma) for the primary in the peritoneal epithelium and mesothelial cancer organizations, clinical rare. Can be categorized as pathological adenomatoid mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM).
Peritoneal mesothelioma (peritoneal mesothelioma) for the primary in the peritoneal epithelium and mesothelial cancer organizations, clinical rare. Can be categorized as pathological adenomatoid mesothelioma (adenomatoid mesothelioma), cystic mesothelioma (cystic mesothelioma) and malignant mesothelioma (peritoneal malignant mesothelioma, PMM). The first two are benign. Cystic mesothelioma more common in women, the cause is unknown, occur in the pelvic or accessories around, showing single or multiple cystic masses; patients often palpable abdominal mass due to the treatment. Malignant peritoneal mesothelioma (PMM) account for about 30% of malignant mesothelioma; its occurrence is closely related with exposure to asbestos, about 5% of patients had history of exposure; asbestos fiber intake by mouth, after translocation through the intestinal wall into the peritoneal and pleural metastasis from disease or from. From exposure to asbestos to diagnosis, the disease incubation period of up to 25 to 40 years. But the domestic 1951 ~ 1993 20 reported in the literature 161 cases of PMM in only 1 case had history of exposure to asbestos. ZHOU Ya-kang and other reported 47 cases of mesothelioma there are eight cases of malignant peritoneal mesothelioma, as well as the author collected two cases have history of exposure to asbestos. In the absence of asbestos-exposed populations, its incidence rate is about 1 person / 1 million person-years may be related to certain viral infections and genetic factors. PMM has reported 1 cases of foreign patients come into contact with more than 40 years ago, thorium dioxide colloid (Thorotrast). PMM often occurs in men over the age of 40. Visceral or parietal peritoneum can suffer from; and tumors can be a direct violation of abdominal and pelvic organs; 50% ~ 70% of patients with lymphatic and / or hematogenous metastasis of liver, kidney, adrenal gland, lung, bone and so on.

Treatment

PMM moderately sensitive to chemotherapy drug. Preoperative induction chemotherapy, surgery and postoperative adjuvant chemotherapy could reduce tumor recurrence and improve 3-year survival rate.

PMM effects of chemical treatment of certain drugs doxorubicin, cisplatin, carboplatin, bleomycin and domestic anti-cancer drugs Eiemene so. Vincristine, fluorouracil, cyclophosphamide, mitomycin, also worth a try. Doxorubicin (Adriamycin, ADM) for each adult 30 ~ 60mg/m2, every 3 weeks a time, intravenous or intraperitoneal injection, total dose not exceed 550mg/m2. Adverse reactions to cardiac toxicity, as the, and there is accumulation of sex, and the total dose-related; followed by bone marrow suppression, gastrointestinal reactions and hair loss.

Cisplatin (Cisplatin, DDP, cis-platinum) Adult per 80 ~ 120mg/m2, every 3 weeks a time; or 20mg/m2, used in conjunction 5 days every 3 weeks for a course of treatment, intravenous injection. Adverse reactions are nephrotoxicity, ototoxicity, neurotoxicity, gastrointestinal reactions and inhibit bone marrow. Mannitol was added to reduce the accumulation in renal tubules.

Carboplatin (Carboplatin, CBP) for adults for each 300 ~ 400mg/m2, 5% glucose solution or saline, the diluted to the concentration of 0.5mg/ml solution, intravenous drip, repeated every 3 ~ 4 weeks, or 100mg / d by adding 500ml of 5% glucose solution intravenously qd for 5 days; 3 ~ 4 weeks to repeat one time. Can also be used for each intraperitoneal injection of 300 ~ 500mg per week, an times.

Bleomycin (Bleomycin, BLM) for adults 15 ~ 30mg, dissolved in an appropriate saline or 5% glucose solution in the deep intramuscular injection, intravenous injection or intravenous drip, 2 times per week; also be replaced by a second depending on the circumstances / d, or several times a week. Can also be used intraperitoneal injection of 60mg slowly dissolved. Stey intraperitoneal injection with BLM treatment of 1 case PMM patients, the results of ascites disappeared after stopping does not occur again, survive more than 3 years. However, BLM intraperitoneal injection of large doses can cause pneumonia-like symptoms, or pulmonary fibrosis; In addition, fever, gastrointestinal reactions more common, occurring allergic individual patients.

Taxol (Paclitaxel) This product is extracted from the bark of Taxus anticancer drugs, by inducing and promoting tubulin polymerization and stability to prevent depolymerization of microtubules, inhibit cell division and proliferation. Paclitaxel can inhibit mitotic microtubule network required for regeneration, prevent the formation of the mitotic spindle leading to chromosome breaks, inhibition of tumor cell replication. Dose of 135 ~ 175 mg/m2, diluted in normal saline or 5% glucose solution intravenously. Repeated every 3 weeks. 12 hours before treatment should be given dexamethasone 20 mg, 30 ~ 60 minutes ago to be intravenous diphenhydramine 50 mg and cimetidine 300 mg or ranitidine 200 mg, to prevent allergic reactions. Cis-platinum combined with about 66.7% of patients on the force and capability by its toxicity. Adverse reactions are bone marrow suppression, allergic reactions, arthralgia, myalgia, gastrointestinal reactions, peripheral neuropathy, syncope, ataxia, and injection site pain and swelling and so on.

Eiemene (Elemene) Curcuma extract of traditional Chinese medicine to the anti-cancer active substance; chest, intra-abdominal perfusion in the treatment of malignant chest, ascites has good curative effect. In as far as possible after the extraction ascites by intraperitoneal injection of 200 ~ 400mg/m2 usage, 1 ~ 2 times a week. The incidence of adverse reactions was 20% ~ 70%, mainly fever, chills and pain; such as a pre-injection of a small amount of narcotic drugs and hormones, are able to prevent them; other allergic reactions, gastrointestinal reactions.

Cyclophosphamide (CTX) for adults for each 600 ~ 1200mg, week 1 ~ 2 times, intravenous injection. After treatment of bone marrow suppression, gastrointestinal reactions and hemorrhagic adverse events than those in common bladder Yandeng.

Vincristine (VCR) for adults per 2.5 ~ 8mg/m2, week 1, intravenous injection, total volume of 60 ~ 80mg, major adverse reactions of bone marrow suppression.

Methotrexate (MTX) for adults every 15 ~ 50mg, week 1 ~ 2 times, muscle or intravenously. Side effects are bone marrow suppression, gastrointestinal reactions, stomatitis, liver and kidney dysfunction, etc., long-term medication can cause pulmonary fibrosis.