疗效:有高质量的证据表明,培美曲塞联合顺铂(中位生存时间为 12.1 个月)在提高生存率方面优于单独使用顺铂(中位生存时间为 9.3 个月)。[48]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;21:2636-2644.http://www.ncbi.nlm.nih.gov/pubmed/12860938?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
疗效:有高质量的证据表明,培美曲塞联合顺铂(中位生存时间为 12.1 个月)在提高生存率方面优于单独使用顺铂(中位生存时间为 9.3 个月)。[48]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;21:2636-2644.http://www.ncbi.nlm.nih.gov/pubmed/12860938?tool=bestpractice.com
术后死亡风险:有中等质量的证据显示,胸膜切除术联合去皮质术(术后死亡率约为 4%)后的生存率优于胸膜外肺切除术 (EPP)(术后死亡风险为 4%~15%)的生存率。[40]Rusch VW, Piantadosi S, Holmes EC. The role of extrapleural pneumonectomy in malignant pleural mesothelioma. A Lung Cancer Study Group trial. J Thorac Cardiovasc Surg. 1991;102:1-9.http://www.ncbi.nlm.nih.gov/pubmed/2072706?tool=bestpractice.com[41]Zellos L, Jaklitsch MT, Al-Mourgi MA, et al. Complications of extrapleural pneumonectomy. Semin Thorac Cardiovasc Surg. 2007;19:355-359.http://www.ncbi.nlm.nih.gov/pubmed/18395638?tool=bestpractice.com[42]Flores RM, Pass HI, Seshan VE, et al. Extrapleural pneumonectomy versus pleurectomy/decortication in the surgical management of malignant pleural mesothelioma: results in 663 patients. J Thorac Cardiovasc Surg. 2008;135:620-626, 626.e1-e3.http://www.ncbi.nlm.nih.gov/pubmed/18329481?tool=bestpractice.com
系统评价或者受试者>200名的随机对照临床试验(RCT)。
术后死亡风险:有中等质量的证据显示,胸膜切除术联合去皮质术(术后死亡率约为 4%)后的生存率优于胸膜外肺切除术 (EPP)(术后死亡风险为 4%~15%)的生存率。[40]Rusch VW, Piantadosi S, Holmes EC. The role of extrapleural pneumonectomy in malignant pleural mesothelioma. A Lung Cancer Study Group trial. J Thorac Cardiovasc Surg. 1991;102:1-9.http://www.ncbi.nlm.nih.gov/pubmed/2072706?tool=bestpractice.com[41]Zellos L, Jaklitsch MT, Al-Mourgi MA, et al. Complications of extrapleural pneumonectomy. Semin Thorac Cardiovasc Surg. 2007;19:355-359.http://www.ncbi.nlm.nih.gov/pubmed/18395638?tool=bestpractice.com[42]Flores RM, Pass HI, Seshan VE, et al. Extrapleural pneumonectomy versus pleurectomy/decortication in the surgical management of malignant pleural mesothelioma: results in 663 patients. J Thorac Cardiovasc Surg. 2008;135:620-626, 626.e1-e3.http://www.ncbi.nlm.nih.gov/pubmed/18329481?tool=bestpractice.com