RESUMO
PURPOSE: To compare treatment modalities and investigate potential prognostic factors for survival in patients with malignant pleural mesothelioma (MPM). METHODS: The present study has investigated the data of 150 patients with MPM who were examined and treated in our center from 2005 to 2012. RESULTS: The study included 87 male (58% and 63 female (42) patients. Surgical resection (pleurectomy/decortications (P/D), and extrapleural pneumonectomy (EPP)) was performed in 32 (36.7%) patients; 87 patients (58%) received chemotherapy alone and 16 (10.7%) had surgery, chemotherapy and radiotherapy (trimodal treatment). The median progression free and overall survival (PFS and OS) for all patients were 10.6 and 14.8 months, respectively. No statistically significant difference was observed between the patients who received pemetrexed/cisplatin (N=54) and gemcitabine/cisplatin (N=28) in terms of PFS and OS (p=0.145, p=0.244, respectively). Also, no statistically significant difference was registered between operated and non operated patients (PFS and OS, p=0.416, p=0.095, respectively). There was no difference in both PFS and OS rates between patients who had P/D or EPP (p=0.87, p=0.652, respectively). Log rank analysis: Eastern Cooperative Oncology Group performance status (ECOG PS) (p=0.018), histology (p<0.001), stage (p<0.001) and leukocytosis (p=0.005) were found to be significant prognostic factors of OS. At multivariate analysis, ECOG PS (p=0.016) and stage (p<0.001) were independent prognostic factors for OS. CONCLUSION: Median OS was approximately 1 year. ECOG PS, histological type, stage and presence of leukocytosis were prognostic factors that affected both PFS and OS. EPP or P/D surgical options did not provide difference in terms of survival. Survival rates in patients who received a combination of platinum analogues with pemetrexed or gemcitabine as front-line chemotherapy were similar.
Assuntos
Intervalo Livre de Doença , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/cirurgia , Mesotelioma/tratamento farmacológico , Mesotelioma/cirurgia , Neoplasias Pleurais/tratamento farmacológico , Neoplasias Pleurais/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cisplatino/administração & dosagem , Terapia Combinada , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Feminino , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/radioterapia , Masculino , Mesotelioma/patologia , Mesotelioma/radioterapia , Mesotelioma Maligno , Pessoa de Meia-Idade , Neoplasias Pleurais/patologia , Neoplasias Pleurais/radioterapia , Procedimentos Cirúrgicos Torácicos , Resultado do Tratamento , Turquia , GencitabinaRESUMO
BACKGROUND: Inappropriate anti-tuberculosis (TB) treatment, particularly at the beginning of the disease, is a major cause of drug resistance. This survey was performed to evaluate doctors' approaches to the diagnosis and treatment of TB. METHOD: The study was conducted in 12 cities, each from a different geographical region of Turkey. A prepared questionnaire about their academic careers and experience in TB and its treatment was distributed to the doctors. RESULTS: The research group consisted of 1,112 doctors. The mean age was 32.7 +/- 6.6 years. The results showed that 75.9% of the doctors had insufficient knowledge about TB. The results of the study further showed that chest specialists, female doctors, physicians who work in a first stage hospital, doctors who had previously diagnosed TB and those who had access to a microbiology laboratory had a better level of knowledge about tuberculosis and its treatment than other doctors. CONCLUSION: A great diversity was seen between daily practice of doctors and national guidelines about TB. Educational programmes conducted by specialists in TB control may help to standardize and increase the knowledge of TB.
