2009年11月25日星期三

improve traditional survival rates among malignant pleural mesothelioma patients

Recently published in the medical journal Lung Cancer, a clinical trial on trimodality therapy for mesothelioma found the combination of surgery, chemotherapy and radiotherapy (radiation) to improve traditional survival rates among malignant pleural mesothelioma patients.

The clinical trial included 35 participants with malignant pleural mesothelioma, an aggressive form of cancer that affects the lining of the lungs. Mesothelioma can also affect the lining of the abdomen (peritoneal mesothelioma), heart (pericardial mesothelioma), or testicles (testicular mesothelioma). Pleural mesothelioma is the most common form of the disease, accounting for approximately 75 percent of malignant mesothelioma cases.

All participants of the trial were treated with a radical pleurectomy surgery, which is a type of surgery that competes against the more commonplace extrapleural pneumonectomy as a surgery option for pleural mesothelioma patients. Both surgeries are cytoreductive (which aims to reduce the amount of cancer cells present in the body) and seek to remove all tumors. However, radical pleurectomy is a less invasive surgery because it removes the pleura (the lining of the lung) and not the entire lung as in an extrapleural pneumonectomy.

Following the surgery, all participants underwent four cycles of chemotherapy with Cisplatin and Permetrexed. This treatment was followed by radiation therapy approximately four to six weeks after the radical pleurectomy.

Researchers stated, "The aim of our prospective study was to analyze the feasibility and describe the long-term outcomes of patients treated with RP [radical pleurectomy] as surgical therapy modality in a standardized trimodality therapy concept." Because not all patients are healthy enough to withstand a surgery as extensive as the extrapleural pneumonectomy, a radical pleurectomy could be a better option and thus warrants further research.

The results of this study were quite promising, with overall median survival at 30 months (the average mesothelioma patient survives four to 18 months after diagnosis). One-, two- and three-year survival rates were 69 percent, 50 percent and 31 percent, respectively. These results were so positive that researchers stated, "The relative small number of patients enrolled in this study protocol limits the results of the presented study… Overall survival might be affected by further still undefined tumor biological factors and non-surgical therapy modalities. Furthermore these high survival rates could be attributed to the patient selection."

Mesothelioma studies like this one are being conducted worldwide and continue to produce promising results and new mesothelioma treatment options for patients. The results from this study showed so much potential that researchers "Believe that RP [radical pleurectomy] as a surgical strategy allows patients to capitalize on all the aspects that a multimodality treatment approach has to offer without compromising the surgical oncological result and thus we believe RP is a cornerstone of the promising long-term results achieved in our pilot study. The observed and theoretical benefits of this trimodality treatment approach warrant confirmation in larger multi-center prospective controlled studies."

Additional information on mesothelioma can be found through the Mesothelioma Center.

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