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Vol.47 No.6 contents | Japanese/English |
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- The 22nd Lung Cancer Mass Screening Seminar -
Epidemiological Studies on Asbestos-related Diseases in Japan, and Multicenter Clinical Trials for Malignant Pleural Mesothelioma
Takashi Nakano11Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Japan
Asbestos is a generic term for 6 fibrous silicate minerals, whose extreme toxicities are closely related to its fibrous nature. With decreases in heavy occupational exposure to asbestos, pulmonary fibrosis, i.e. asbestosis, is waning in incidence, but asbestos-related pleural diseases including mesothelioma have been increasing in most industrialized countries. Mesothelioma, which has a strong etiological relationship with asbestos exposure, is increasing in incidence and is predicted to continue to increase into the next decade. Most asbestos exposure occurs via occupational exposure, therefore, mesothelioma rates are higher in those areas around industries utilizing blue asbestos, such as shipbuilding and asbestos factories. In June 2005, an asbestos factory in Amagasaki, Hyogo, documented a significant number of asbestos-related deaths among their employees as well as the residents who lived around the factory, which triggered social and medico-legal problems of asbestos-related diseases in Japan. A major concern is the cases without any proven occupational asbestos exposure, which represent 17% of the total cases. Are these mesotheliomas due to environmental exposure in the vicinity of asbestos factories or due to indoor exposure? In response, the Ministry of the Environment has initiated retrospective research on mesothelioma in Amagasaki, Hyogo, Sennan, Osaka, and Tosu, Saga to evaluate the potential effects of environmental exposure. Malignant mesothelioma is a highly lethal and particularly refractory tumor for which treatments have been far from satisfactory in achieving clinical responses. The diffuse nature of the disease makes it difficult for the surgeon to perform a radical resection, and combined modality treatments have been attempted in order to establish standard treatment for mesothelioma. Newer chemotherapeutic regimens, including pemetrexed and cisplatin combination, have shown encouraging response rates and survival benefits for mesothelioma. Multicenter clinical trials are planned in Japan for malignant pleural mesothelioma just now, which will lead to implementation of scientific mesothelioma register.
key words: Mesothelioma, Asbestos, Pemetrexed, Extrapleural pneumonectomy, Clinical trial
JJLC 47 (6): 761-768, 2007
