The Role of Post-Surgical Radiation in Mesothelioma Survival

More research is needed before we will know whether radiotherapy after mesothelioma surgery can improve mesothelioma survival. That’s the conclusion of a newly-published assessment performed by an Egyptian doctor.

The study, which tracked more than 2,000 mesothelioma patients over a ten-year period, found that, while some radiotherapy patients did live longer, the benefits did not extend to patients with a certain mesothelioma subtype.

Radiotherapy and Mesothelioma Survival

To compile the report, clinical oncologist Omar Abdel-Rahman, MD, of Ain Shams University in Cairo used the Surveillance, Epidemiology, and End Results (SEER) database to identify 2,166 mesothelioma patients who underwent mesothelioma surgery between 2000 and 2013.

Four hundred and sixty-nine of the mesothelioma patients identified were treated with radiotherapy after their surgery.

“Both before and after propensity score matching, overall survival was better in the postoperative radiotherapy group,” writes Dr. Abdel-Rahman in the German medical journal Strahlenther Onkologie.

Radiotherapy Benefits Not for All Mesothelioma Patients

On the surface, it seems to be good news for patients facing the prospect of mesothelioma surgery. However, the report goes on to say that postoperative radiotherapy did not improve the survival in patients with sarcomatoid mesothelioma, a rarer but even more deadly form of the asbestos cancer.

In addition, when the data was further analyzed. It became evident that not receiving postoperative radiotherapy did not correlate with worse mesothelioma survival.

The factors that did not bode well for mesothelioma survival included sarcomatoid histology, cancer spread to the lymph nodes, and being over age 70.

“Evidence from this analysis is insufficient on its own to routinely recommend postoperative radiotherapy for surgically resected malignant pleural mesothelioma,” concludes the report, which calls for “large-scale prospective clinical trials” of radiotherapy for mesothelioma.

Evidence Grows for Radiotherapy

But the use of radiation as part of multi-modal mesothelioma treatment does not hinge on a single study. This fall, doctors at Mount Sinai Medical Center reached a more optimistic conclusion regarding radiotherapy and mesothelioma survival.

Their study of more than 14,000 patients with non-metastatic pleural mesothelioma found that a third of the mesothelioma patients who had radiotherapy were still alive two years after treatment compared to just 19.4 percent of those who had no radiotherapy.

After adjusting for demographic, pathologic and treatment factors, the team determined that study subjects who had both radiotherapy and surgery had a lower mortality rate than those who had either radiotherapy or surgery alone.

That study concluded that increased use of radiotherapy in the treatment of malignant pleural mesothelioma was warranted.

Sources:

Abdel-Rahman, O, “Role of postoperative radiotherapy in the management of malignant pleural mesothelioma: A propensity score matching of the SEER database”, Junary 2, 2017, Strahlenther Onkologie, Epub ahead of print

Ohri, N, et al, “Definitive Radition Therapy is Associated with Improved Survival in Non-Metastatic Malignant Pleural Mesothelioma”, October 1, 2015, International Journal of Radiation Oncology, Biology, Physics