Precision Mesothelioma Treatment with Planning Models

The combination of two special planning models is a big step forward in mesothelioma treatment. Results show these models make sure that important organs are protected during cancer treatment.

Enhancing Mesothelioma Treatment

Mesothelioma is a serious condition that affects the lining of organs like the lungs. It is caused by exposure to a toxic material called asbestos. Treating it is hard because the target area is large and close to other important organs like the heart.

The Icahn School of Medicine has been using a special planning model called RapidPlan (RP) to help with mesothelioma treatment. This model was designed for cases where patients had surgery, leaving them with two intact lungs.

Maximizing Effectiveness, Minimizing Risk

In this new study, researchers wanted to see if adding another method could make the RP model even better. This method is called multi-criteria optimization (MCO). Together they protect nearby organs without hurting the treatment’s effectiveness.

They looked at data from 57 patients who had received a type of therapy called Volumetric Modulated Arc Therapy (VMAT). This therapy uses special arcs and photons to target the mesothelioma. The researchers trained a computer model to estimate the doses of radiation. They looked at different organs like the heart, lungs, and stomach. For 12 new patients, they made treatment plans using RP alone and a combination of RP and MCO.

The results showed that when they used RP and MCO together, the amount of radiation reaching the heart dropped significantly. This is an important result because too much radiation to the heart can lead to more health problems.

The same improvements were seen in other organs, like the lung and the esophagus. These results were not just a small change. They were statistically significant, meaning they were very likely to make a real difference for patients.

However, some organs didn’t see a big change with RP and MCO. For example, the liver and stomach didn’t get as much benefit from the combination. Also, the part of the lung that received radiation stayed within safe limits for all plans.

In the end, combining RP and MCO proved to be a big step forward in mesothelioma treatment at Mount Sinai. It helped to make sure that the important organs like the heart and lungs got the protection they needed while effectively treating the cancer.

This is especially crucial because too much radiation to the heart and lungs can lead to a condition called radiation pneumonitis. By using both RP and MCO, doctors can better plan the treatment based on each patient’s unique health and history. This gives them the best chance at beating mesothelioma.

Source

Dumane VA, Chum T, Tseng TC, Sheu R, Liu T, Rosenzweig. Multi-criteria optimization and RapidPlan for improved organs at risk sparing in treatment planning of malignant pleural mesothelioma. Int J Radiat Oncol Biol Phys. 2023;117(2):e662-e663. doi: 10.1016/j.ijrobp.2023.06.2100. https://www.sciencedirect.com/science/article/pii/S0360301623065343