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• W2023150371 abstract "We read with great interest the article entitled “Prevention of Malignant Seeding After Invasive Diagnostic Procedures in Patients With Pleural Mesothelioma” by Drs. Boutin, Rey, and Viallat (CHEST 1995; 108:754–58). Epidemiologic and case control studies have shown that malignant pleural mesothelioma constitutes an important public health problem in Turkey as a result of environmental exposure to asbestos or erionite.1Bariş Yİ Bilir N Artvinli M et al.An epidemiological study on an Anatolian village environmentally exposed to tremolite asbestosis.Br J Ind Med. 1988; 45: 838-840PubMed Google Scholar,2Selçuk ZT CÇöplü L Emri S et al.Malignant pleural mesothelioma due to environmental mineral fiber exposure in Turkey: analysis of 135 cases.Chest. 1992; 102: 790-796Abstract Full Text Full Text PDF PubMed Scopus (93) Google Scholar As the authors stated, chest wall implantation after any invasive diagnostic and therapeutic procedure is not uncommon and causes intractable pain. This complication is also familiar to the villagers who live in some endemic regions and they are reluctant to accept biopsies. We found that tumor seeding to the chest wall occurred in 5 of 19 patients (26%) treated with a combination of cisplatin, mitomycin-C, and alpha interferon.3Tansan S Emri S Selçuk T et al.Treatment of malignant pleural mesothelioma with cisplatin, mitomycin C, and alpha interferon.Oncology. 1994; 51: 348-351Crossref PubMed Scopus (41) Google Scholar The median interval after the invasive procedures and detection of local implants was 8 months (range, 3 to 11 months). Thus, because malignant seeding poses a management problem despite chemotherapy, we designed a new prospective trial. Until now 11 patients received local radiotherapy to sites of previous biopsies, incisions, and chest tubes. Within 1 month after invasive procedures, these sites are irradiated with 10 to 12 MeV electron beams (SL-25; Philips; Crawley Sussex, United Kingdom) with a safety margin of 1 to 1.5 cm and with a total dose of 4,200 cGy in 12 fractions using a conventional fractionation system. The energy of electron beam was determined by measuring the thickness of the chest wall on thoracic CT. Six patients in early surgical stage (stage 1) underwent pleurectomy/decortication, and all patients received intrapleural chemotherapy with cisplatin (100 mg/m2 postoperatively either thoracotomy or video-assisted thoracic surgery, on day 1 and on day 8) followed by systemic chemotherapy (cisplatin 75 mg/m2 IV, and mitomycin-C 10 mg/m2 IV on day 1, repeated every 21 days for 4 courses). As of November 1995 with a median follow-up of 6 months (range, 2 to 12 months), no malignant seeding was detected and accrual continues. This finding supports that local radiotherapy to the sites of invasive procedures should be included in the management of malignant pleural mesothelioma." @default.
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• W2023150371 title "Preventive Irradiation After Invasive Diagnostic and Therapeutic Procedures in Malignant Pleural Mesothelioma" @default.
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• W2023150371 doi "https://doi.org/10.1378/chest.109.6.1665-b" @default.
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