Chemotherapy & Surgery – Brigham and Women’s Hospital – USA
In this 2006 study from Brigham and Women’s Hospital in Boston, the researchers wanted to find out if adding heated cisplatin chemotherapy during surgery could increase life expectancy for patients with pleural mesothelioma.
The idea was to first give patients a pleurectomy (surgery) and then bathe the surgical area with heated cisplatin, a type of chemotherapy. The chemo was heated to 107.6 degrees Fahrenheit and left in contact with the surgical area for about 1 hour.
Sixty-one patients were enrolled in the study and the median age was 71 years.
Median survival time of all patients in the study was 9 months, and the median survival time of patients who received the highest doses of the heated cisplatin was 18 months. The doctors concluded that there was “An apparent dose-related survival benefit …”
Patients: This phase I to II study involved 61 patients with mesothelioma, 44 of which received the combination (surgery and chemotherapy) treatment. These patients had a median age of 71 years, ranging from 50 to 82 years and 73% were male.
Treatment: 44 patients had surgery (macroscopic complete resection) followed by treatment with the chemotherapy drug cisplatin by lavage.
Toxicity: 10 patients had a grade 5 toxicity (death) from major morbidity of grade 3+, respiratory failure/adult respiratory distress syndrome, and multi-organ failure. Grade 3 and 4 toxicities included atrial fibrillation, deep vein thrombosis, technical complications, respiratory failure/adult respiratory distress syndrome, pneumonia and renal toxicity.
Results: The median survival time of all 61 registered patients was 9.3 months; those that had surgical resection and cisplatin had a median survival time of 13 months. Among these patients, 35 were given a higher dose of cisplatin and had a median survival of 18 months, and 7 were still alive 30-50 months after the surgery. Those given a lower dose had a median survival time of 6 months (and all died within 15 months).
Correspondence: David Sugarbaker, M.D.
See all conventional treatment results for mesothelioma.