Araştırma Makalesi
Yıl 2022,
, 15 - 21, 15.03.2022
Öz
Amaç: Malign mezotelyoma, mezotel hücrelerinden kaynaklanan agresif bir malignitedir. Prognozu kötüdür ve medyan genel sağkalım 12 aydır. Malign plevral mezotelyomanın altta yatan en önemli nedeni daha önceki asbest maruziyetidir. Bu çalışmada malign mezotelyoma tanısı olan hastaların demografik özellikleri ve tedavi sonuçlarının değerlendirilmesi amaçlandı. Gereç ve Yöntem: Çalışmada tıbbi onkoloji bölümüne Ocak 2009 ile Mayıs 2020 tarihleri arasında başvuran malign mezotelyoma tanılı hastaların verileri retrospektif olarak değerlendirildi. Toplam 26 hastanın verilerine ulaşıldı. Veriler hasta dosyalarından ve dijital veri işleme sisteminden elde edildi. Verilerin değerlendirilmesinde istatistiksel analiz programı kullanıldı. Yüzde ve ortalamalar ile dağılımları hesaplandı. Bulgular: Hastaların medyan yaşı 65 (33-80) ve ortalama yaşı 61,8±12,9 idi. Hastaların sekizi erkek ve 18’i kadındı. Hastaların hiçbirinde mesleki asbest maruziyeti öyküsü yoktu. En sık etkilenen bölge plevraydı. Bir bifazik, bir sarkomatoid ve 24 epiteloid malign mezotelyoma vardı. Evre 1 hastalığı olan dört, evre 2 hastalığı olan bir, evre 3 hastalığı olan yedi ve evre 4 hastalığı olan 14 hasta mevcuttu. İlk sıra tedavide en çok pemetrekset-sisplatin kombinasyonu tercih edilirken, ikinci sırada en çok kullanılan tedavi tek ajan gemsitabin idi. Sonuç: Bu çalışmada, topraktaki asbest nedeniyle Türkiye’nin endemik bir bölgesinden gelen malign mezotelyoma hastalarının verileri değerlendirildi. Bu veriler ışığında, literatür ile uyumlu sağkalım sonuçları ve literatüre uygun tedavilerin yapıldığı sonucuna varıldı. Gelecekteki çalışmalarla farklı coğrafi bölgelerden elde edilecek veriler, hastalığın ortaya çıkışını önlemeye ve daha etkili tedavi stratejileri ile daha iyi klinik sonuçlara ulaşılmasına yardımcı olacaktır
Anahtar Kelimeler
Kaynakça
- Arnold DT, Maskell NA. Biomarkers in mesothelioma. Ann Clin Biochem. 2018; 55 (1): 49-58.
- Fels Elliott DR, Jones KD. Diagnosis of Mesothelioma. Surg Pathol Clin. 2020; 13 (1): 73-89.
- Scherpereel A, Opitz I, Berghmans T, et al. ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural mesothelioma. Eur Respir J. 2020; 55 (6).
- Sekido Y. Molecular pathogenesis of malignant mesothelioma. Carcinogenesis. 2013; 34 (7): 1413-9.
- Hiriart E, Deepe R, Wessels A. Mesothelium and Malignant Mesothelioma. J Dev Biol. 2019; 7 (2).
- McCambridge AJ, Napolitano A, Mansfield AS, et al. Progress in the Management of Malignant Pleural Mesothelioma in 2017. J Thorac Oncol. 2018; 13 (5): 606-23.
- Solbes E, Harper RW. Biological responses to asbestos inhalation and pathogenesis of asbestos-related benign and malignant disease. J Investig Med. 2018; 66 (4): 721-7.
- Metintas S, Ak G, Metintas M. A review of the cohorts with environmental and occupational mineral fiber exposure. Arch Environ Occup Health. 2019; 74 (1-2): 76-84.
- Marinaccio A, Binazzi A, Marzio DD, et al. Pleural malignant mesothelioma epidemic: incidence, modalities of asbestos exposure and occupations involved from the Italian National Register. International journal of cancer. 2012; 130 (9): 2146-54.
- Farioli A, Ottone M, Morganti AG, et al. Radiation-induced mesothelioma among long-term solid cancer survivors: a longitudinal analysis of SEER database. Cancer medicine. 2016;5(5):950-9.
- Treasure T. What is the best approach for surgery of malignant pleural mesothelioma? It is to put our efforts into obtaining trustworthy evidence for practice. The Journal of thoracic and cardiovascular surgery. 2016; 151 (2): 307-9.
- Gemba K, Fujimoto N, Aoe K, et al. Treatment and survival analyses of malignant mesothelioma in Japan. Acta oncologica (Stockholm, Sweden). 2013; 52 (4): 803-8.
- Gemba K, Fujimoto N, Kato K, et al. National survey of malignant mesothelioma and asbestos exposure in Japan. Cancer science. 2012; 103 (3): 483-90.
- Beebe-Dimmer JL, Fryzek JP, Yee CL, et al. Mesothelioma in the United States: a Surveillance, Epidemiology, and End Results (SEER)-Medicare investigation of treatment patterns and overall survival. Clinical epidemiology. 2016; 8: 743-50.
- Galateau-Salle F, Churg A, Roggli V, Travis WD. The 2015 World Health Organization Classification of Tumors of the Pleura: Advances since the 2004 Classification. J Thorac Oncol. 2016; 11 (2): 142-54.
- Milano MT, Zhang H. Malignant pleural mesothelioma: a population-based study of survival. Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer. 2010; 5 (11): 1841-8.
- Metintas M, Ak G, Erginel S, et al. A retrospective analysis of malignant pleural mesothelioma patients treated either with chemotherapy or best supportive care between 1990 and 2005 A single institution experience. Lung Cancer. 2007; 55 (3): 379-87.
- Musk AW, Olsen N, Alfonso H, et al. Predicting survival in malignant mesothelioma. The European respiratory journal. 2011; 38 (6): 1420-4.
- Henley SJ, Larson TC, Wu M, et al. Mesothelioma incidence in 50 states and the District of Columbia, United States, 2003-2008. International journal of occupational and environmental health. 2013; 19 (1): 1-10.
- Zalcman G, Mazieres J, Margery J, et al. Bevacizumab for newly diagnosed pleural mesothelioma in the Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS): a randomised, controlled, open-label, phase 3 trial. Lancet (London, England). 2016; 387 (10026): 1405-14.
- Carbone M, Ly BH, Dodson RF, et al. Malignant mesothelioma: facts, myths, and hypotheses. J Cell Physiol. 2012; 227 (1): 44-58.
- Forest F, Patoir A, Dal Col P, et al. Nuclear grading, BAP1, mesothelin and PD-L1 expression in malignant pleural mesothelioma: prognostic implications. Pathology. 2018; 50 (6): 635-41.
- Sugarbaker DJ, Flores RM, Jaklitsch MT, et al. Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients. The Journal of thoracic and cardiovascular surgery. 1999; 117 (1): 54-63; discussion -5.
- Cantini L, Hassan R, Sterman DH, Aerts J. Emerging Treatments for Malignant Pleural Mesothelioma: Where Are We Heading? Front Oncol. 2020; 10: 343.
- Batirel HF, Metintas M, Caglar HB, et al. Adoption of pleurectomy and decortication for malignant mesothelioma leads to similar survival as extrapleural pneumonectomy. J Thorac Cardiovasc Surg. 2016; 151 (2): 478-84.
- Rimner A, Zauderer MG, Gomez DR, et al. Phase II Study of Hemithoracic Intensity-Modulated Pleural Radiation Therapy (IMPRINT) As Part of Lung-Sparing Multimodality Therapy in Patients With Malignant Pleural Mesothelioma. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2016; 34 (23): 2761-8.
- Batirel HF, Metintas M, Caglar HB, et al. Trimodality treatment of malignant pleural mesothelioma. J Thorac Oncol. 2008; 3 (5): 499-504.
- Hastürk S, Tastepe I, Unlü M, Cetin G, Baris YI. Combined chemotherapy in pleurectomized malignant pleural mesothelioma patients. J Chemother. 1996; 8 (2): 159-64.
- Shaikh F, Zauderer MG, von Reibnitz D, et al. Improved Outcomes with Modern Lung-Sparing Trimodality Therapy in Patients with Malignant Pleural Mesothelioma. Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. 2017; 12 (6): 993-1000.
- Bertoglio P, Aprile V, Ambrogi MC, Mussi A, Lucchi M. The role of intracavitary therapies in the treatment of malignant pleural mesothelioma. J Thorac Dis. 2018; 10 (Suppl 2): S293-s7.
- Tsao AS, Lindwasser OW, Adjei AA, et al. Current and Future Management of Malignant Mesothelioma: A Consensus Report from the National Cancer Institute Thoracic Malignancy Steering Committee, International Association for the Study of Lung Cancer, and Mesothelioma Applied Research Foundation. J Thorac Oncol. 2018; 13 (11): 1655-67.
- Calabrò L, Morra A, Giannarelli D, et al. Tremelimumab combined with durvalumab in patients with mesothelioma (NIBIT-MESO-1): an open-label, non-randomised, phase 2 study. Lancet Respir Med. 2018; 6 (6): 451-60.
- Scherpereel A, Mazieres J, Greillier L, et al. Nivolumab or nivolumab plus ipilimumab in patients with relapsed malignant pleural mesothelioma (IFCT-1501 MAPS2): a multicentre, open-label, randomised, non-comparative, phase 2 trial. Lancet Oncol. 2019; 20 (2): 239-53.
- Sinn K, Mosleh B, Hoda MA. Malignant pleural mesothelioma: recent developments. Curr Opin Oncol. 2021; 33 (1): 80-6.
- Abbas S, Simsek Ozek N, Emri S, Koksal D, Severcan M, Severcan F. Diagnosis of malignant pleural mesothelioma from pleural fluid by Fourier transform-infrared spectroscopy coupled with chemometrics. J Biomed Opt. 2018; 23 (10): 1-14.
- Leong SL, Zainudin R, Kazan-Allen L, Robinson BW. Asbestos in Asia. Respirology (Carlton, Vic). 2015; 20 (4): 548-55.
- Robinson BM. Malignant pleural mesothelioma: an epidemiological perspective. Annals of cardiothoracic surgery. 2012; 1 (4): 491-6.
- Inai K. Pathology of mesothelioma. Environmental health and preventive medicine. 2008;13(2):60-4.
- Baas P, Fennell D, Kerr KM, Van Schil PE, Haas RL, Peters S. Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of oncology : official journal of the European Society for Medical Oncology. 2015;26 Suppl 5:v31-9.
- Vogelzang NJ, Rusthoven JJ, Symanowski J, et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol. 2003; 21 (14): 2636-44.
- van den Bogaert DP, Pouw EM, van Wijhe G, et al. Pemetrexed maintenance therapy in patients with malignant pleural mesothelioma. Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer. 2006; 1 (1): 25-30.
- Castagneto B, Botta M, Aitini E, et al. Phase II study of pemetrexed in combination with carboplatin in patients with malignant pleural mesothelioma (MPM). Annals of oncology: official journal of the European Society for Medical Oncology. 2008; 19 (2): 370-3.
- Santoro A, O'Brien ME, Stahel RA, et al. Pemetrexed plus cisplatin or pemetrexed plus carboplatin for chemonaïve patients with malignant pleural mesothelioma: results of the International Expanded Access Program. Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer. 2008; 3 (7): 756-63.
- Woolhouse I, Bishop L, Darlison L, et al. British Thoracic Society Guideline for the investigation and management of malignant pleural mesothelioma. Thorax. 2018; 73 (Suppl 1): i1-i30.
- Kindler HL, Ismaila N, Armato SG, 3rd, et al. Treatment of Malignant Pleural Mesothelioma: American Society of Clinical Oncology Clinical Practice Guideline. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2018; 36 (13): 1343-73.
- Buikhuisen WA, Hiddinga BI, Baas P, van Meerbeeck JP. Second line therapy in malignant pleural mesothelioma: A systematic review. Lung cancer (Amsterdam, Netherlands). 2015; 89 (3): 223-31.
- Ak G, Metintas S, Akarsu M, Metintas M. The effectiveness and safety of platinum-based pemetrexed and platinum-based gemcitabine treatment in patients with malignant pleural mesothelioma. BMC Cancer. 2015; 15: 510.
Yıl 2022,
, 15 - 21, 15.03.2022
Öz
Aim: Malignant mesothelioma is an aggressive malignancy originating from the mesothelial cells. It has a dismal prognosis and median overall survival is 12 months. The most important underlying cause of malign mesothelioma is previous asbestos exposure. In this study, it was aimed to evaluate the demographical features and outcomes of the patients with diagnosis of malign mesothelioma. Materials and Methods: The data of malign mesothelioma patients referred to the department of medical oncology between January 2009 and May 2020 were retrospectively analyzed. The data of a total number of 26 patients were obtained. Data were collected from patient files and digital data processing system. Statistical analyze program was used in the evaluation of the data. The distributions were calculated with percentages and medians.
Results: The median age of the patients was 65 (33-80) and mean age was 61.8±12.9. Of the patients, eight were male and 18 were female. None of our patients had a history of occupational asbestos exposure. The most common involved site was pleura. There was one mixed, one sarcomatoid and 24 epithelioid malign mesotheliomas. There were four patients with stage 1 disease, one patient with stage 2 disease, seven patients with stage 3 disease, and 14 patients with stage 4 disease. The most preferred first-line treatment was pemetrexed-cisplatin combination and the most common second-line therapy was single agent gemcitabine. Conclusion: In this study, the data of malign mesothelioma patients from an endemic region of Turkey because of asbestos in the soil were evaluated. In light with this data, it was concluded that outcome results were concordant with the literature and treatments appropriate to the literature was performed. Data collection with future studies from different regions will help to prevent disease occurrence and achieving better clinical outcomes with more effective treatment strategies.
Anahtar Kelimeler
Kaynakça
- Arnold DT, Maskell NA. Biomarkers in mesothelioma. Ann Clin Biochem. 2018; 55 (1): 49-58.
- Fels Elliott DR, Jones KD. Diagnosis of Mesothelioma. Surg Pathol Clin. 2020; 13 (1): 73-89.
- Scherpereel A, Opitz I, Berghmans T, et al. ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural mesothelioma. Eur Respir J. 2020; 55 (6).
- Sekido Y. Molecular pathogenesis of malignant mesothelioma. Carcinogenesis. 2013; 34 (7): 1413-9.
- Hiriart E, Deepe R, Wessels A. Mesothelium and Malignant Mesothelioma. J Dev Biol. 2019; 7 (2).
- McCambridge AJ, Napolitano A, Mansfield AS, et al. Progress in the Management of Malignant Pleural Mesothelioma in 2017. J Thorac Oncol. 2018; 13 (5): 606-23.
- Solbes E, Harper RW. Biological responses to asbestos inhalation and pathogenesis of asbestos-related benign and malignant disease. J Investig Med. 2018; 66 (4): 721-7.
- Metintas S, Ak G, Metintas M. A review of the cohorts with environmental and occupational mineral fiber exposure. Arch Environ Occup Health. 2019; 74 (1-2): 76-84.
- Marinaccio A, Binazzi A, Marzio DD, et al. Pleural malignant mesothelioma epidemic: incidence, modalities of asbestos exposure and occupations involved from the Italian National Register. International journal of cancer. 2012; 130 (9): 2146-54.
- Farioli A, Ottone M, Morganti AG, et al. Radiation-induced mesothelioma among long-term solid cancer survivors: a longitudinal analysis of SEER database. Cancer medicine. 2016;5(5):950-9.
- Treasure T. What is the best approach for surgery of malignant pleural mesothelioma? It is to put our efforts into obtaining trustworthy evidence for practice. The Journal of thoracic and cardiovascular surgery. 2016; 151 (2): 307-9.
- Gemba K, Fujimoto N, Aoe K, et al. Treatment and survival analyses of malignant mesothelioma in Japan. Acta oncologica (Stockholm, Sweden). 2013; 52 (4): 803-8.
- Gemba K, Fujimoto N, Kato K, et al. National survey of malignant mesothelioma and asbestos exposure in Japan. Cancer science. 2012; 103 (3): 483-90.
- Beebe-Dimmer JL, Fryzek JP, Yee CL, et al. Mesothelioma in the United States: a Surveillance, Epidemiology, and End Results (SEER)-Medicare investigation of treatment patterns and overall survival. Clinical epidemiology. 2016; 8: 743-50.
- Galateau-Salle F, Churg A, Roggli V, Travis WD. The 2015 World Health Organization Classification of Tumors of the Pleura: Advances since the 2004 Classification. J Thorac Oncol. 2016; 11 (2): 142-54.
- Milano MT, Zhang H. Malignant pleural mesothelioma: a population-based study of survival. Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer. 2010; 5 (11): 1841-8.
- Metintas M, Ak G, Erginel S, et al. A retrospective analysis of malignant pleural mesothelioma patients treated either with chemotherapy or best supportive care between 1990 and 2005 A single institution experience. Lung Cancer. 2007; 55 (3): 379-87.
- Musk AW, Olsen N, Alfonso H, et al. Predicting survival in malignant mesothelioma. The European respiratory journal. 2011; 38 (6): 1420-4.
- Henley SJ, Larson TC, Wu M, et al. Mesothelioma incidence in 50 states and the District of Columbia, United States, 2003-2008. International journal of occupational and environmental health. 2013; 19 (1): 1-10.
- Zalcman G, Mazieres J, Margery J, et al. Bevacizumab for newly diagnosed pleural mesothelioma in the Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS): a randomised, controlled, open-label, phase 3 trial. Lancet (London, England). 2016; 387 (10026): 1405-14.
- Carbone M, Ly BH, Dodson RF, et al. Malignant mesothelioma: facts, myths, and hypotheses. J Cell Physiol. 2012; 227 (1): 44-58.
- Forest F, Patoir A, Dal Col P, et al. Nuclear grading, BAP1, mesothelin and PD-L1 expression in malignant pleural mesothelioma: prognostic implications. Pathology. 2018; 50 (6): 635-41.
- Sugarbaker DJ, Flores RM, Jaklitsch MT, et al. Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients. The Journal of thoracic and cardiovascular surgery. 1999; 117 (1): 54-63; discussion -5.
- Cantini L, Hassan R, Sterman DH, Aerts J. Emerging Treatments for Malignant Pleural Mesothelioma: Where Are We Heading? Front Oncol. 2020; 10: 343.
- Batirel HF, Metintas M, Caglar HB, et al. Adoption of pleurectomy and decortication for malignant mesothelioma leads to similar survival as extrapleural pneumonectomy. J Thorac Cardiovasc Surg. 2016; 151 (2): 478-84.
- Rimner A, Zauderer MG, Gomez DR, et al. Phase II Study of Hemithoracic Intensity-Modulated Pleural Radiation Therapy (IMPRINT) As Part of Lung-Sparing Multimodality Therapy in Patients With Malignant Pleural Mesothelioma. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2016; 34 (23): 2761-8.
- Batirel HF, Metintas M, Caglar HB, et al. Trimodality treatment of malignant pleural mesothelioma. J Thorac Oncol. 2008; 3 (5): 499-504.
- Hastürk S, Tastepe I, Unlü M, Cetin G, Baris YI. Combined chemotherapy in pleurectomized malignant pleural mesothelioma patients. J Chemother. 1996; 8 (2): 159-64.
- Shaikh F, Zauderer MG, von Reibnitz D, et al. Improved Outcomes with Modern Lung-Sparing Trimodality Therapy in Patients with Malignant Pleural Mesothelioma. Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer. 2017; 12 (6): 993-1000.
- Bertoglio P, Aprile V, Ambrogi MC, Mussi A, Lucchi M. The role of intracavitary therapies in the treatment of malignant pleural mesothelioma. J Thorac Dis. 2018; 10 (Suppl 2): S293-s7.
- Tsao AS, Lindwasser OW, Adjei AA, et al. Current and Future Management of Malignant Mesothelioma: A Consensus Report from the National Cancer Institute Thoracic Malignancy Steering Committee, International Association for the Study of Lung Cancer, and Mesothelioma Applied Research Foundation. J Thorac Oncol. 2018; 13 (11): 1655-67.
- Calabrò L, Morra A, Giannarelli D, et al. Tremelimumab combined with durvalumab in patients with mesothelioma (NIBIT-MESO-1): an open-label, non-randomised, phase 2 study. Lancet Respir Med. 2018; 6 (6): 451-60.
- Scherpereel A, Mazieres J, Greillier L, et al. Nivolumab or nivolumab plus ipilimumab in patients with relapsed malignant pleural mesothelioma (IFCT-1501 MAPS2): a multicentre, open-label, randomised, non-comparative, phase 2 trial. Lancet Oncol. 2019; 20 (2): 239-53.
- Sinn K, Mosleh B, Hoda MA. Malignant pleural mesothelioma: recent developments. Curr Opin Oncol. 2021; 33 (1): 80-6.
- Abbas S, Simsek Ozek N, Emri S, Koksal D, Severcan M, Severcan F. Diagnosis of malignant pleural mesothelioma from pleural fluid by Fourier transform-infrared spectroscopy coupled with chemometrics. J Biomed Opt. 2018; 23 (10): 1-14.
- Leong SL, Zainudin R, Kazan-Allen L, Robinson BW. Asbestos in Asia. Respirology (Carlton, Vic). 2015; 20 (4): 548-55.
- Robinson BM. Malignant pleural mesothelioma: an epidemiological perspective. Annals of cardiothoracic surgery. 2012; 1 (4): 491-6.
- Inai K. Pathology of mesothelioma. Environmental health and preventive medicine. 2008;13(2):60-4.
- Baas P, Fennell D, Kerr KM, Van Schil PE, Haas RL, Peters S. Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of oncology : official journal of the European Society for Medical Oncology. 2015;26 Suppl 5:v31-9.
- Vogelzang NJ, Rusthoven JJ, Symanowski J, et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol. 2003; 21 (14): 2636-44.
- van den Bogaert DP, Pouw EM, van Wijhe G, et al. Pemetrexed maintenance therapy in patients with malignant pleural mesothelioma. Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer. 2006; 1 (1): 25-30.
- Castagneto B, Botta M, Aitini E, et al. Phase II study of pemetrexed in combination with carboplatin in patients with malignant pleural mesothelioma (MPM). Annals of oncology: official journal of the European Society for Medical Oncology. 2008; 19 (2): 370-3.
- Santoro A, O'Brien ME, Stahel RA, et al. Pemetrexed plus cisplatin or pemetrexed plus carboplatin for chemonaïve patients with malignant pleural mesothelioma: results of the International Expanded Access Program. Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer. 2008; 3 (7): 756-63.
- Woolhouse I, Bishop L, Darlison L, et al. British Thoracic Society Guideline for the investigation and management of malignant pleural mesothelioma. Thorax. 2018; 73 (Suppl 1): i1-i30.
- Kindler HL, Ismaila N, Armato SG, 3rd, et al. Treatment of Malignant Pleural Mesothelioma: American Society of Clinical Oncology Clinical Practice Guideline. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2018; 36 (13): 1343-73.
- Buikhuisen WA, Hiddinga BI, Baas P, van Meerbeeck JP. Second line therapy in malignant pleural mesothelioma: A systematic review. Lung cancer (Amsterdam, Netherlands). 2015; 89 (3): 223-31.
- Ak G, Metintas S, Akarsu M, Metintas M. The effectiveness and safety of platinum-based pemetrexed and platinum-based gemcitabine treatment in patients with malignant pleural mesothelioma. BMC Cancer. 2015; 15: 510.
Toplam 47 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 15 Mart 2022 |
| Gönderilme Tarihi | 20 Şubat 2021 |
| Yayımlandığı Sayı | Yıl 2022 |