The reason for the prolonged survivals noted in our study, despite the high local recurrence rates, are unclear.
Raleigh, NC (PRWEB) August 29, 2013
Research published in The Annals of Cardiothoracic Surgery and reported by Surviving Mesothelioma finds some encouraging results among malignant pleural mesothelioma patients who underwent lung-sparing mesothelioma surgery and photodynamic therapy through the University of Pennsylvania Health System.
The surgical approach used in the study, called pleurectomy, removes the entire pleural lining where mesothelioma starts. It may also involve the removal of mesothelioma cells from the surface of the lung. Unlike the more radical and risky extrapleural pneumonectomy (EPP), it leaves the lungs intact.
Each of the study subjects also had intraoperative photodynamic therapy (PDT), a light-based cancer treatment during which the patient receives a photosensitizing compound which is activated during surgery by a light. PDT is believed to help fight mesothelioma through several mechanisms, including killing malignant cells directly, destroying their vasculature, and/or prompting an anti-tumor immune response.The authors of the new study compare the power of light to produce chemical reactions with the process of photosynthesis in plants.
Of the 38 patients who had the pleurectomy/PDT combination, 97% had Stage III or Stage IV mesothelioma. The overall median survival from the time of surgery was 31.7 months - a full year longer than most mesothelioma patients survive from the time of their diagnosis. Survival was even better (median of 41.2 months) among the 31 patients who had the epithelioid type of mesothelioma. Of these, 11 patients who had no spread of mesothelioma to their mediastinal lymph nodes had a median survival of 57.1 months. There was a 3% mortality rate from the surgery itself.
Given the fact that most mesothelioma patients die within 12 months of diagnosis, the survival rates in the University of Pennsylvania study are unusual. The authors point out that these impressive survival rates were achieved despite the fact that mesothelioma recurred in 66% of cases.
"The reason for the prolonged survivals noted in our study, despite the high local recurrence rates, are unclear," the authors write. But they go on to theorize that having two lungs may have meant a better state of health and more treatment options for patients when their cancer did return. They also note that the PDT-treatment may have "induced an ‘autologous tumor vaccine’ effect" in the cancer cells that were left behind, effectively protecting patients against the negative impact of recurrent mesothelioma.
This pilot study has prompted additional research into PDT for mesothelioma which is now ongoing at The University of Pennsylvania.The original research is highlighted in The Annals of Cardiothoracic Surgery. (Friedberg, JS, "Radical pleurectomy and photodynamic therapy for malignant pleural mesothelioma", November 2012, Annals of Cardiothoracic Surgery, pp. 472-480. http://www.annalscts.com/article/view/1214/1605)
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