European researchers have a bit of good news for patients coping with the pain that often accompanies late stage malignant pleural mesothelioma. They have found evidence that radiotherapy, which is sometimes prescribed to treat this pain, really can make a difference.
The authors, including cancer researchers from both Scotland and Norway, note that, although radiation is often used to treat mesothelioma pain, there has been little research to support the practice. As part of a multi-center phase II clinical trial on the use of radiotherapy for mesothelioma pain, patients were assessed for baseline pain and other symptoms and then treated with 20 Gy of radiation in 5 daily fractions.
Mesothelioma pain was evaluated at 5 weeks and again at 12 weeks after each patient’s treatment. Also evaluated in the weeks following their radiotherapy were quality of life, shortness of breath, mood, and toxic side effects from the radiation itself.
Of the forty mesothelioma patients recruited from three UK cancer centers, five patients reported that they were free of pain and another fourteen demonstrated “clinically meaningful” improvement by the 5-week mark. “Based on a complete case analysis of the 30 patients assessable at week 5, 47% of patients alive at week 5 had an improvement in their pain,” writes author Dr. Nicholas MacLeod of the Edinburgh Cancer Research Centre in Scotland.
Although the patients did see improvements in their pain, there were no measurable changes in other key symptoms or in their quality of life following their palliative radiotherapy. The authors conclude that radiotherapy is effective for pain control in mesothelioma and they recommend more studies to help determine the best radiotherapy regimen for optimum pain relief.
Radiation therapy helps to alleviate pain in people with mesothelioma by reducing the size of tumors in the lung lining, which reduces pressure on the lungs and chest. In some patients, this can also help lessen symptoms such as shortness of breath. There is also evidence that, by reducing the size of tumors and making it harder for to cancer to spread, palliative radiotherapy can help extend life.
MacLeod, N, et al, “Is radiotherapy useful for treating pain in mesothelioma? A phase II trial”, February 4, 2015, Journal of Thoracic Oncology, Epub ahead of print