Adding a technique called Cold Plasma Coagulation to the mix when using surgery and intra-operative chemotherapy seems to help protect mesothelioma patients against certain complications, according to a new study.
Mesothelioma, a malignancy that affects the linings around the lungs and internal organs, is caused by asbestos exposure and is notoriously difficult to treat. Depending on the stage of their cancer and their health status, most patients receive a combination of treatments which may include chemotherapy, radiation, radical surgery (Extrapleural pneumonectomy or EPP), or pleurectomy and decortication (P/D), a less radical surgical approach. Even with these various combinations, many patients succumb to the disease within 18 months of diagnosis.
In an effort to improve mesothelioma survival rates, surgeons in recent years have begun combining pleurectomy and decortication with heated chemotherapy (hyperthermic intrathoracic chemoperfusion or HITHOC) that is washed through the effected body cavity during surgery. While results of this combination therapy have been promising, there is the potential for damaging the pericardium (lining around the heart) or the diaphragm, leading to heart damage or the accidental spread of cancer cells into the abdomen.
Now, researchers in Germany believe they have found a way to protect the pericardium and the diaphragm during P/D, while still allowing mesothelioma patients to benefit from the surgery and the HITHOC treatment. In the study, Cold Plasma Coagulation (CPC) was used to destroy tumor cells on the pleura, diaphragm and pericardium before HITHOC was administered.
Patients in the study all had Stage III pleural mesothelioma. None of them suffered any cardiotoxic effects as the result of their treatment and none had had a recurrence of their cancer one year after surgery. The researchers concluded that Cold Plasma Coagulation was a safe and potentially beneficial addition to a multimodal treatment approach for mesothelioma patients.
In their abstract, the authors noted that the number of cases of mesothelioma continues to rise and is not expected reach its peak until 2015. They caution, “We consider our trial as a pilot study. To evaluate potential survival benefits using this [Cold Plasma] technique, larger trials are mandatory.”
The study titled “Cold-Plasma Coagulation in the Treatment of Malignant Pleural Mesothelioma: Results of a Combined Approach”, was published in the online journal Interactive Cardiovascular and Thoracic Surgery.
Hoffman, Martin et al, “Cold-Plasma Coagulation in the Treatment of Malignant Pleural Mesothelioma: Results of a Combined Approach”, Interactive Cardiovascular and Thoracic Surgery, 2010; 10: 502-505.