Study Finds "Excellent" Mesothelioma Results with Surgery/Radiation Combo, According to Surviving Mesothelioma

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A combination of lung-sparing surgery and high-dose radiation may offer a "concrete therapeutic approach" to this hard-to-treat cancer.

This approach represents a concrete therapeutic option for malignant pleural mesothelioma.

Surviving Mesothelioma is reporting that medical researchers in Italy have achieved some of the best mesothelioma survival results seen in recent years using a combination approach that includes surgery, chemotherapy, and high-dose radiotherapy.

Twenty patients with malignant pleural mesothelioma underwent a surgical procedure called pleurectomy/decortication (P/D) to remove the diseased pleural lining and surrounding tissues. Unlike the more radical extrapleural pneumonectomy (EPP), P/D does not include removal of a lung.

Following surgery, patients were given 50Gy of radiation delivered in 25 fractions to the side of their chest where the mesothelioma was removed. Areas that were suspicious for cancer regrowth on an FDG-PET scan were given a simultaneous "boost" of radiation to 60Gy. Nineteen patients in the study were also treated with a combination of the chemotherapy drugs cisplatin and pemetrexed.

It took a median of 29 months for mesothelioma to begin to regrow after treatment. Although most mesothelioma patients die of the disease within 18 months of diagnosis, the median overall survival for all mesothelioma patients in the new study was an impressive 33 months. The researchers used the Kaplan-Meier analysis tool to estimate a 70% overall survival rate at 2 years and an overall survival rate of 49% at 3 years. Most patients did not experience regrowth of their mesothelioma tumors in the original spot, although 7 patients did eventually experience metastasis (spread) of the cancer to other locations in the body.

In a summary of their findings in the journal Lung Cancer, the researchers call these tumor-control and survival results "excellent" and say the combination is an important option for people with this hard-to-treat cancer. "A median overall survival of 33 months and a 3-year overall survival rate of 49% are among the best observed in recent studies, supporting the idea that this approach represents a concrete therapeutic option for malignant pleural mesothelioma," they write.

The original study appears in a recent issue of Lung Cancer. (Minatel, E, et al, "Radical pleurectomy/decortication followed by high dose of radiation therapy for malignant pleural mesothelioma. Final results with long-term follow-up", October 27, 2013, Lung Cancer, Epub ahead of print.

For nearly ten years, Surviving Mesothelioma has brought readers the most important and ground-breaking news on the causes, diagnosis and treatment of mesothelioma. All Surviving Mesothelioma news is gathered and reported directly from the peer-reviewed medical literature. Written for patients and their loved ones, Surviving Mesothelioma news helps families make more informed decisions.

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Michael Ellis
Cancer Monthy
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