New Radiotherapy Can Double Two-Year Survival for Mesothelioma
May 14, 2019
A novel radiotherapy regimen can double the chances of surviving two or more years with pleural mesothelioma, according to Dr. Marco Trovo at University Hospital of Udine in Italy.
Trovo is the lead author of a study involving 108 patients treated for malignant mesothelioma between 2014 and 2018 at the National Cancer Institute in Aviano, Italy.
He presented the findings this week at the annual European Society for Therapeutic Radiology and Oncology convention in Milan.
“Radiotherapy has evolved dramatically in the last few years, so we wanted to see if it could now be used to prevent cancer from spreading to nearby tissue, hopefully bringing improvements in survival,” Trovo said during his presentation. “This research shows a clear survival benefit.”
He believes the findings have the potential to change standard-of-care treatment for pleural mesothelioma, a rare and aggressive cancer that starts in the lining around the lungs.
Radiation Can Provide Survival Benefits
All mesothelioma patients in the study had some form of surgery, but none of which provided a complete resection of cancer. Patients also underwent adjuvant chemotherapy treatment.
The randomized trial included half the patients receiving more traditional, palliative radiation treatment that is provided for patients at most cancer centers.
The other half in the study received a more aggressive hemi-thoracic radiotherapy, which included 25 treatments delivered to the side of the body where the majority of the tumor burden was located.
It also included one higher-dose radiation treatment to the tumor-burden center.
Of the patients who received only the palliative radiation, 28% were still alive two years later.
Nearly 60% of participants who received the more aggressive treatment regimen were alive after two years.
“We believe this should be considered the new standard of care for these patients,” said Trovo, head of the Radiotherapy Department at Azienda Sanitaria Universitaria Integrata di Udine. “There is an urgent need for more effective treatments for mesothelioma.”
Previous Studies Were Inconclusive
Typical survival rates for pleural mesothelioma can vary depending on the age of the patient, stage of diagnosis and treatment delivered.
According to one study, only 41% of those over the age of 65 live more than one year.
The percentage dropped significantly for those with inoperable disease. Less than 25% of those over 65 live two years or more.
Approximately 20% of those in the study receiving the aggressive radiation experienced inflammation of the lung, known as radiation pneumonitis. Other side effects included nausea, weakness and inflammation of the esophagus.
Previous studies have been mixed in evaluating the benefits of radiation therapies for mesothelioma.
Researchers of a study published in early 2019 in the Journal of Clinical Oncology found no benefit to radiation when given in combination with chemotherapy and advised against using it because of the side effects.
Another recent study from the Abramson Cancer Center at the University of Pennsylvania showed a consistent benefit in survival times when novel proton radiation therapy was used in combination with photodynamic therapy.
A 2016 study by the Icahn School of Medicine and Mount Sinai Hospital showed a significant increase in survival when “definitive radiation therapy” was used.
The Icahn study compared a 33% two-year survival with a 19.5% survival for mesothelioma patients who did not have any radiation therapy.
Trovo believes the findings should encourage patients to seek care at a specialty center that has the most technologically advanced radiotherapy and the resources to handle potential side effects.
“This is an extremely positive result that brings good news to patients with this rare and difficult-to-treat cancer,” said Dr. Umberto Ricardi, president of the European Society for Therapeutic Radiology and Oncology.