Study Illustrates Increased Survival Rates After Multimodal Treatment with Radiotherapy
January 19, 2011
A recent study exploring the effects of radiotherapy alone or in conjunction with chemotherapy as post-surgical treatment reveals that survival rates, especially in Stage II patients, are improved by a multimodal approach involving radiotherapy.
While there is no known cure for mesothelioma, medical professionals agree that multimodality therapy is the most effective form of mesothelioma treatment. Surgery can remove early localized tumors, however, mesothelioma is often diagnosed late in its progression, at which time further treatment is usually necessary to provide significant palliative benefits.
The study, led by Dr. Hesham El Hossieny, tracked the treatment of 110 malignant pleural mesothelioma patients between 1999 and 2007. Of the 110 patients, 46 received surgery, chemotherapy and radiation therapy. This aggressive course of treatment was found to increase median survival, especially in patients with Stage II and III cancer.
Less aggressive treatment combining radiation and chemotherapy was given to 38 patients while the other 26 received only radiation. Only 24.5 percent of these patients who received radiotherapy as part of their mesothelioma treatment displayed no response at all in tumor size or severity of symptoms such as dyspnea, chest pain or cough.
Treatment methods were evaluated two to three weeks after the end of radiotherapy using CT scans, clinical examinations and patients’ personal reports.
When the study was published in 2010, 25 of the participants were alive and completely free of the disease. Twenty-three of these patients had undergone treatment while in Stage II and the other two were in Stage III.
Recurrence rates were the lowest when radiation was delivered via high dose hemithorax (half of the thorax, referring to one side of the chest) irradiation, prescribed to 81 percent of the patients in this study. This form of radiotherapy targets a very large area and may potentially damage healthy surrounding tissues. To be eligible for this treatment, patients must have otherwise strong overall organ function.
Twenty-two patients in the study developed local recurrence within eight months of the conclusion of treatment. Another 22 patients experienced a spreading of cancerous cells within seven months.
The results from Hossieny’s study reflected those from similar studies illustrating the effectiveness of radiotherapy in extending survival rates. The median mesothelioma survival rate for patients in this study was 16 months. In the past five years, the average length of survival after diagnosis is reported around 10 to 11 months.
Within the study, 63.6 percent of patients had a survival rate of at least 12 months. A total of 41.6 percent of patients with Stage II cancer and 33.3 percent of Stage III patients lived for 18 months after completion of treatment.
Considering current treatment options, this study illustrates the superiority of multimodal treatment with radiation in increasing survival rates, especially in Stage II mesothelioma patients. Although mesothelioma survival rates and treatment candidacy both depend on a number of factors, a doctor will be able to discuss options, including radiotherapy, with each individual patient.