Mesothelioma Radiation Therapy
Radiation therapy (RT) is a common cancer treatment known to reduce pain among mesothelioma patients. In fact, numerous clinical trials have shown that, on its own, RT does not prolong survival in most mesothelioma patients. Instead, RT is best used with other treatments. Doctors commonly use some combination of surgery, chemotherapy and/or radiation therapy to try to remove, kill or shrink tumors. If easing pain is the only goal, radiation could be selected as a solo treatment.
More than half of the patients treated with radiation experience some sort of benefit. Side effects are generally easier on a patient than side effects from chemotherapy. The therapy itself is fairly straightforward. A specialist applies ionizing radiation to cancerous tumors. The radiation damages DNA and kills tumor cells.
Radiation therapy is not used to treat all forms of mesothelioma, particularly peritoneal mesothelioma. This type of mesothelioma affects the abdominal area, which contains vital organs and a number of different tissues. Not all of these organs and tissues are afflicted with cancer, so it is not necessary to treat them. But radiation therapy can be toxic to the small intestine, liver, kidneys and other organs. This limits any potential benefit to the therapy.
Learn More about Radiation Treatment
Radiation is one of many cancer treatments covered in The Mesothelioma Center’s complimentary informational packet. It also contains information about the clinical trials, top doctors and cancer centers. Fill out this form to get your free packet mailed to you.
Roles of Radiation Therapy in Mesothelioma Treatment
Several decades of studies on mesothelioma RT have proven the therapy is effective for easing pain and symptoms. Therapy also has proven to prevent a recurrence of local tumors – called "seeding" – along surgical and tube incision sites (such as biopsy tracts, drain tube sites, surgical incisions or thoracotomy sites).
Palliative Pain Relief
- Radiation therapy alleviates pain by reducing the size of mesothelioma tumors, which relieves pressure on the lungs and chest.
Seeding Prevention
- Radiation therapy along incision sites is common, as seeding occurs in 20 to 50 percent of mesothelioma patients who undergo these procedures. Even modest RT at surgery or drain tube sites can help.
Patients with early stage mesothelioma may qualify for three types of treatment – a combination of surgery, chemotherapy and radiation, called trimodal treatment – that offers the most life expectancy.
Some patients can be deemed not eligible for surgery. For them, a combination of chemotherapy and RT may be chosen to relieve pain and improve life expectancy. Some patients also do not qualify for such a comprehensive treatment but can have surgery followed by radiation. Clinical trials have shown that such a two-pronged treatment approach can relieve pain and improve survival rates.
Side Effects of Radiation Therapy
Common side effects of radiation therapy may include the following:
Side Effects of Radiation Therapy
- Acute Side Effects
- Skin redness
- Esophagitis
- Fatigue
- Nausea
- Long-Term Side Effects
- Radiation pneumonitis
- Cardiac damage
- Radiation myelitis
- Liver radiation damage
Other potential side effects can include pleural effusions, collapsed lung(s) and calcification of the lymph nodes. Pleural effusions are typically reported within six months of the initial radiation treatment, if they develop at all, according to research.
Types of Radiation Therapy for Mesothelioma
There are different types of RT available: Three-Dimensional Radiation Treatment, Intensity-Modulated Radiation Therapy; and Brachytherapy.
Three-Dimensional Radiation Treatment (3D-CRT)
This allows physicians, using detailed imaging scans, to customize a radiation dose for a three-dimensional tumor. Radiation is delivered with a number of fixed beams. This treatment can spare the liver and heart from receiving as much radiation, and protects the kidneys more than IMRT (see below).
Intensity-Modulated Radiation Therapy (IMRT)
This involves a more complex planning process than 3D-CRT and applies non-uniform radiation beam intensities across the tumor. IMRT is more complicated to deliver than 3D-CRT but provides better tumor coverage with reduced exposure to healthy tissue. The liver and opposite lung are usually spared from radiation, but the kidney under the tumor usually receives some radiation. Recently, some doctors have employed this type of therapy in combination with chemotherapy and extrapleural pneumonectomy (EPP).
Brachytherapy
Brachytherapy is used less often than the other two types but is still being researched. It is known as interstitial radiation therapy or sealed source radiation therapy. This treatment uses small radioactive rods – called seeds or implants – inserted into the tumor area. Brachytherapy provides high doses of radiation in a small area, typically sparing surrounding healthy tissue. In some cases, seeds are used after an invasive procedure (pleural aspiration, biopsy, thoracoscopy or thoracentesis).
More Information about Radiation Therapy?
Mesothelioma specialists can take different treatment approaches depending upon the type and stage of mesothelioma you are diagnosed with, so seeking a second opinion is almost always beneficial. If you are interested in seeing a specialist, the Mesothelioma Center’s Doctor Match Program has experience working with the top mesothelioma doctors and medical professionals from around the country. Fill out a Doctor Match Program form to use this free program.
Sources:
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2698270/?tool=pmcentrez
- http://www.jacmp.org/index.php/jacmp/article/viewArticle/2850/1596
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652430/?tool=pmcentrez
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1805064/?tool=pmcentrez
- http://www.americanbrachytherapy.org/aboutBrachytherapy/BrachyFAQFinal2.pdf
- Stevens, C.W., Forster, K.M., Smythe W.R. (2006). Radiotherapy for Mesothelioma. In K. O'Byrne & V. Rusch (Eds.), Malignant Pleural Mesothelioma (pp. 315-333). New York: Oxford University Press.
- Giuseppe, S., et al. (2008). Non-Surgical Treatment of Malignant Plueral Mesothelioma: Radiotherapy and Chemotherapy. In Edt. By A. Baldi, Mesothelioma from Bench Side to Clinic (pp. 405-412). New York: Nova Science Publishers, Inc.
- Chahinian, A. (2002). Treatment of Malignant Mesothelioma: Radiotherapy and Chemotherapy. In B. Robinson & A. Chahinian (Eds.), Mesothelioma (pp. 185-199). London: Martin Dunitz.
- Smith, R., Hahn, S. (2005). Treatment of Mesothelioma with Radiotherapy. In Pass, H., Vogelzang, N. & Carbone, M. (Eds.), Malignant Mesothelioma (pp. 616-627). New York: Springer.
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