Doctors Describe "Concrete Therapeutic Approach" for Mesothelioma

A team of medical researchers in Italy have achieved what they are calling “excellent” tumor control and survival results in malignant pleural mesothelioma patients using a combination of surgery, chemotherapy, and radiotherapy.

Caused by exposure to asbestos, mesothelioma typically spreads quickly across the lung-encasing membrane called the pleura. There is no known cure but treatments are improving. In the current prospective study, 20 malignant pleural mesothelioma patients underwent radical pleurectomy/decortication followed by high doses of radiation.

After surgeons removed as much of the visible mesothelioma tumor and surrounding tissue as possible, patients received 50Gy of radiation to the effected side of their chest, delivered in 25 fractions. Regions of particular concern for mesothelioma regrowth got an extra radiation “boost” to 60Gy. Nineteen of the patients also received chemotherapy with a combination of cisplatin and pemetrexed.

When the researchers calculated how well mesothelioma tumors were controlled by the multi-modal treatment approach and how long patients survived, the results were encouraging. The median overall survival was 33 months. The Kaplan-Meier analysis tool was used to estimate that 70% of mesothelioma patients would still be alive at 2 years and nearly half (49%) would still be living at 3 years. Given that the majority of mesothelioma patients die within a year of diagnosis, the study’s survival results are impressive.

“High dose radiation therapy following radical pleurectomy/decortication led to excellent loco-regional control and survival results in malignant pleural mesothelioma patients,” the researchers report in the journal Lung Cancer. They go on to say that the overall survival rates using this combination of surgery, chemotherapy, and high-dose radiation are “among the best observed in recent studies.”

While seven patients did eventually develop metastatic mesothelioma (cancer growth in another area), only three patients had regrowth at the site of the original mesothelioma tumor. The Italian researchers concluded that the study results suggest a “concrete therapeutic approach” for mesothelioma, an aggressive cancer for which there are few viable treatment options.

Source:

Minatel, E, et al, “Radical pleurectomy/decortication followed by high dose of radiation therapy for malignant pleural mesothelioma. Final results with long-term follow-up”, October 27, 2013, Lung Cancer, Epub ahead of print.

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