When fibrosing mediastinitis produces active symptoms or causes significant progressive compression of vital mediastinal structures, a structured treatment strategy is required. At this stage, the choice between medical and interventional management becomes central to the clinical decision.
This protocol addresses patients with symptoms of fibrosing mediastinitis or with significant progressive compression of vital mediastinal structures. In this clinical setting, therapies are typically divided into medical versus interventional approaches.
Medical management centres on corticosteroid therapy as the mainstay, with the greatest benefit seen in specific disease subtypes. Additional medical options are available for patients who require an alternative approach — the complete structured regimen remains in the full protocol.
Clinical targets: improvement in symptoms and reduction in fibrosis findings on chest CT.