Abstract
Background. UK and European guidelines on treatment of mesothelioma recommend combination chemotherapy with Cisplatin/Pemetrexed (CP) in patients with good performance status. In Sunderland CP chemotherapy has been the standard treatment for mesothelioma in selected patients since 2006. The aim of this study was to ascertain the usage of CP for mesothelioma and impact on survival.
Method Study conducted at Sunderland Royal Hospital. Patients diagnosed with malignant mesothelioma between 1998-2011 were included. Data collected: demographics, performance status, comorbidity, histology, treatment. Patients were stratified by date of diagnosis: 1998-2005 and 2006-2011. Factors affecting survival were assessed by Cox's regression analysis.
Results. N=209, median (IQ range) age 69 (63-77) years, male 81.8 %. Histology: Epithelioid 48%; Sarcomatoid 12.6%, Mixed 5.2%, Unspecified 34.2%. Proportion treated with chemotherapy 1998-2005 29.3%, 2006-2011 60.2%; OR 3.65 (2.03-6.5). Median (IQR) survival: 1998-2005 8.2 (3.7-19.3) months; 2006-2011 all patients 9.8 (3.7-15.8) months, patients given CP chemotherapy 12.7 (9.8-22.7) months p > 0.05. On regression analysis treatment with CP appeared to confer a survival benefit HR (95% CI) 0.30 (0.21-0.43). But overall survival was unchanged between 1998-2005 and 2006-2011 HR 0.98 (0.72-1.3).
Conclusion Most patients with malignant mesothelioma are now treated with carboplatin/pemetrexed combination chemotherapy. However overall survival has not improved significantly and the apparent benefit of treatment may be due to patient selection.
- © 2012 ERS
