Radiation & Surgery – University of California, San Francisco
This multimodality therapy took place between January 1995 and September 2000 at Departments of Radiation Oncology, Surgery, and Medicine at the University of California in San Francisco, California.
The treatment consisted of radical pleurectomy/decortication, radiotherapy during the actual surgery, followed by more radiation after the surgery. Some patients were also given chemotherapy. The chemotherapy consisted of 2 to 3 cycles of cyclophosphamide, doxorubicin, and cisplatin.
A total of 32 pleural mesothelioma patients were given this treatment. Two patients died immediately after the surgery. The overall survival was a median of 18.1 months. The researchers concluded that this treatment “might offer an alternative treatment option to those who cannot tolerate extrapleural pneumonectomy.”
Today, this treatment is used less and less as the role of radiation therapy has become less important over time. Nonetheless, radiation therapy as part of a multimodality approach is still used in some centers to try to improve survival time.
Patients: This study involved 28 patients with malignant pleural mesothelioma. (The number of patients started at 32, but several were excluded from the analysis because of various reasons.) Of the 28 patients, two died postoperatively – one died of a pulmonary embolus one day after surgery and the other patient died of acute respiratory arrest with hypotension and multi-organ failure ten days after surgery.
Treatment: The treatment consisted of surgery and radiation. In addition, 12 patients also received chemotherapy. The surgery comprised radical pleurectomy/decortication and the radiation comprised intraoperative radiotherapy (radiation during surgery) followed by external beam radiation.
Toxicity: Major postoperative complications included atrial fibrillation (3 patients) and persistent air leak of more than 7 days (1 patient). The primary side-effects from external beam radiation was radiation-induced pneumonitis, pericarditis, and esophageal stricture.
Results: The overall median survival was 18.1 months.
Correspondence: David Jablons, MD
See all conventional treatment results for mesothelioma.