Isolated thoracic perfusion with chemofiltration for progressive malignant pleural mesothelioma

Figures & data

Table 1 Patients characteristics (mean age 63.4 years, range 43–86 years)

Patients and pretreatments	n	%
Patients included	28	100
Sex
Male	25	89
Female	3	11
Stage
III	8	29
IV	20	71
Prior surgery	5	18
Prior chemotherapy	10	36
Cisplatin/pemetrexed	10	36
Second-line chemotherapy	4	14
Third-line chemotherapy	2	7
Prior radiotherapy	5	18

Figure 1 Cavography and aortography.

Notes: (A) Balloon blocking of aorta and vena cava at the level of the diaphragm. (B) Intercostal arteries feeding the tumor in the visceral pleura in the aortogram.

Figure 2 Scheme of isolated thoracic perfusion.

Figure 3 (A) Mitomycin plasma levels in isolated thoracic perfusion with chemofiltration versus intravenous application. Adapted with permission from Springer Nature book. Toxicity profiles with systemic versus regional chemotherapy. Induction Chemotherapy – Systemic and Locoregional, 2016, 497–506, Aigner KR, Knapp N;⁷ (B) cisplatin plasma levels in the thoracic aorta (dotted line) and in the vena cava (baseline) after intra-arterial pulsatile infusion of 80 mg cisplatin, demonstrating the so-called first-pass effect in intra-arterial chemotherapy. Adapted with permission from Springer Nature book. Toxicity profiles with systemic versus regional chemotherapy. Induction Chemotherapy – Systemic and Locoregional, 2016, 497–506, Aigner KR, Knapp N.⁷

Figure 4 CT scan with a complete response.

Notes: (A) CT scan of the chest of a male patient (76 years old) before therapy. Prior therapy consisted of VATS decortication and pleurodesis of the left lung and 2 cycles of cisplatin/pemetrexed. After this, progressive disease was diagnosed. (B) Complete disappearance of bulky lesions after the second course of isolated perfusion of the chest.
Abbreviations: A, anterior; CT, computed tomography; P, posterior; R, right; VATS, video assisted thoracoscopic surgery.

Figure 5 Kaplan–Meier plot of overall survival of all 28 patients.

Note: Median survival was 12 months, 1-year survival was 49%, and 2-year and 3-year survival was 31%.
Abbreviation: yr, year.

Figure 6 Kaplan–Meier plot of progression-free survival.

Note: Median progression-free survival was 9 months, 1-year progression-free survival was 37.5%, 2-year progression-free survival was 29%.
Abbreviation: yr, year.

AignerKRKnappNToxicity profiles with systemic versus regional chemotherapyAignerKRStephensFOInduction Chemotherapy – Systemic and Locoregional2nd edBerlin, HeidelbergSpringer-Verlag2016497506

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