Another new study has confirmed that a multimodal approach – in which multiple treatments are used together – is the most reliable way to improve survival in patients with malignant pleural mesothelioma.
Doctors in England and Italy have just published their findings on a mesothelioma treatment combination that includes surgery, pleural lavage, radiotherapy and systemic chemotherapy. The study included 102 mesothelioma patients treated between 2004 and 2013 at one of two London hospitals or at the University of Milan.
About three quarters of the patients in the study had the epithelioid variety of mesothelioma, which is the most common form. Eighty percent were male. All of the patients underwent the lung-sparing mesothelioma surgery called pleurectomy/decortication (PD) during which the diseased pleural lining and other at-risk body tissues are removed. This was followed by a rinse with heated povidone-iodine, a solution often used as a surgical disinfectant.
These mesothelioma patients also received both radiotherapy and chemotherapy. Some of them had one or both of these treatments prior to their surgery, while others had them as adjuvant therapies afterward. At 30 days post-surgery, none of the patients had died, although about 30 percent were experiencing postoperative complications.
But the most striking statistic from the multimodality study is that almost a quarter of the mesothelioma patients were still living at the 5-year mark. Mesothelioma is one of the most aggressive cancers, often claiming patients’ lives within a year of diagnosis. But the median survival rate for all of the mesothelioma patients in the newest study was 2 years and 8 months with some living 5 years or more.
The news was most encouraging for the patients with epithelioid mesothelioma. The median survival for these patients was just under 3 years and more than 30 percent were still alive at 5 years. The doctors who conducted the research conclude that their approach is “a safe and well-tolerated multimodality therapy” for pleural mesothelioma.
Although the multimodal approach has become the gold standard for treating mesothelioma, there remains widespread debate over which therapies, and in what order, produce the best results.
Lang-Lazdunski, L, “Pleurectomy/decortication, hyperthermic pleural lavage with povidone-iodine, prophylactic radiotherapy, and systemic chemotherapy in patients with malignant pleural mesothelioma: A 10-year experience.”, February 2015, Journal of Thoracic and Cardiovascular Surgery, pp. 558-566.