Comprehensive treatment of malignant mesothelioma patients after the failure of systemic chemotherapy

► We studied malignant mesothelioma patients in whom systemic chemotherapy had failed. ► One group received cryosurgery, photodynamic therapy and intracavity chemotherapy. ► Patients who received intracavity chemotherapy only comprised the control group. ► Overall survival (OS) was significantly greater with the combined treatment. ► Increased OS was closely associated with repeated treatment. Malignant mesothelioma (MM) is an aggressive neoplasm usually arising from the mesothelial surfaces of the pleural or peritoneal cavity. Currently, no standard therapy is available. The most commonly used therapy is cytoreductive surgery combined with systematic chemotherapy, but the median overall survival (OS) is less than 12months; moreover, treatments are lacking for patients in whom chemotherapy has failed and/or who cannot withstand surgery. We investigated multiple minimally invasive therapies (cryosurgery, photodynamic therapy and intracavity chemotherapy) for the treatment of MM patients in whom systemic chemotherapy had failed. Twenty-seven patients were divided into comprehensive (combination of the three therapies) and palliative (intracavity chemotherapy only) treatment groups. The OS of patients who received comprehensive treatment was significantly longer than that of those who received palliative treatment (median OS: 64 vs. 9months, P