Conventional Treatments & Survival

Conventional treatments for mesothelioma typically consist of surgery, chemotherapy and radiation therapy. Surgery can include any surgical procedure. Chemotherapy includes various drugs that are considered toxic because they work by killing both healthy and cancerous cells. And radiation therapy can be delivered through different methods. For example, radiation such as x-rays or gamma rays may be delivered externally via external beam radiation. Radiation can also be delivered internally by placing radioactive substances such as cesium, iridium, and iodine near or into cancerous cells within the body or administering radionuclides systemically (directly into the bloodstream).

Results of Conventional Treatments Administered to Mesothelioma Patients

Important Note : These are summaries of results of clinical trials that have been made available by Cancer Monthly: The Source for Cancer Treatment Results. The source data are the clinical results reported in the medical literature. To learn more about these treatments click on the icon under "More Information." This will open a new window that will contain the study's abstract. Print out the abstract and share it with your doctor. Your doctor can help you determine if a particular treatment is right for you. For more information about toxicity grades see below. For more treatment results for mesothelioma and many other cancers visit Cancer Monthly.

Treatment Description	Median Survival Rate	Side-Effects	More Information
28 patients were involved. The treatment consisted of surgery and radiation. In addition, 12 patients also received chemotherapy. The surgery comprised radical pleurectomy/ decortication and the radiation comprised intraoperative radiotherapy (radiation during surgery) followed by external beam radiation.	The overall median survival was 18.1 months.	Major postoperative complications included atrial fibrillation (3 patients) and persistent air leak of more than 7 days (1 patient). The primary side-effects from external beam radiation was radiation-induced pneumonitis, pericarditis, and esophageal stricture.	Article
27 patients were involved. The treatment consisted of two chemotherapy drugs, pemetrexed and carboplatin (paraplatin).	Median survival time was 451 days (14.8 months).	Toxicities included hematologic (grade 3-4), and grade 1-3 nausea, vomiting, diarrhea, and stomatitis.	Article
226 patients were part of Group A. Patients in this group received two chemotherapy drugs, pemetrexed and cisplatin (platinol). In addition, most patients were supplemented with folic acid and vitamin B12.	Median survival for patients in Group A was 12.1 months. (Median survival was 13.3 months for those patients who were fully supplemented with folic acid and vitamin B12).	Fourteen patients in Group A died while on the study or within 30 days of the last dose of the study drugs. Three deaths were thought to be possibly related to the drugs. (These deaths occurred before folic acid and vitamin B12 supplementation was initiated.) Other toxicities included grade 3-4 hematologic, nausea, fatigue, vomiting, diarrhea, dehydration, stomatitis, anorexia, febrile neutropenia, infection, and rash.	Article
53 patients were involved. The treatment consisted of two chemotherapy drugs; cisplatin (platinol) and gemcitabine (gemzar).	Median survival was 11.2 months.	Grade 3-4 toxicities included hematologic, diarrhea, infection, neurotoxicity, vomiting, and nausea.	Article
29 patients were involved. The treatment consisted of administration of the chemotherapy drug, vinorelbine (navelbine).	The median overall survival from the time of first treatment was 10.6 months.	Grade 3-4 toxicities included neutropenia, leucopenia, constipation, and phlebitis.	Article
88 patients were involved. The treatment consisted of surgery (thoractomy) and radiation therapy. Sixty-two patients received complete surgical resection with external beam radiation therapy. Five patients received intraoperative radiation therapy in addition to external radiation, and 21 patients were taken off the protocol.	The median survival was 10 months for stage III and IV tumors.	Grade 4 toxicities included skin, esophagus, nausea, and fatigue.	Article
38 patients were involved. The treatment consisted of the chemotherapy drug ifosfamide (IFEX). (In addition, two other drugs were administered - mesna for chemoprotection and G-CSF to increase neutrophil count.)	The median overall survival was 7 months.	There was one treatment-related death from infection, pulmonary edema, and renal failure. Grade 3-4 toxicities included hematologic, cardiovascular, circulatory, dermatologic, flu-like symptoms, gastrointestinal, infection, neurologic, neuromotor, neurosensory, pain, and pulmonary .	Article

Toxicity Grades

Toxicities (or side-effects) are generally graded from one to five. The higher the number, the more toxic were the side-effects from the treatment. There are a number of different toxicity scales (i.e. National Cancer Institute Common Toxicity Criteria version 2.0, World Health Organization) and they are all similar in respect to their grades and definitions. The scale is generally:

1 = Mild side-effects
2 = Moderate side-effects
3 = Severe side-effects
4 = Life Threatening or Disabling side-effects
5 = Fatal

What is included in the table above are the highest grades for one or more toxicities reported for one or more patients. This means that even if only one patient had one example of a grade 4 toxicity and every other patient had grade 2, the grade for that treatment will be reported as a 4.