The search for an effective treatment protocol for mesothelioma provides a challenge to researchers and physicians alike. Now, a recent study indicates that the multi-modality treatment approach that has gained popularity in the last several years is seen as one of the most successful options.
According to a collaborative research project conducted by doctors in England and Italy, the use of a multi-pronged approach that includes surgery, pleural lavage, systemic chemotherapy and radiotherapy provides patients diagnosed with malignant mesothelioma with the longest overall survival rates, with median survival extending far beyond what is seen with single modality approaches.
The physicians followed the progress of over 100 patients who received treatment over a ten year period at the University of Milan or at one of two London hospitals. Of these patients, who were largely male, 75% had been diagnosed with the most common cell type of mesothelioma, known as epithelioid mesothelioma.
Each patient was provided with a variety of treatments, including a surgical procedure known as pleurectomy/decortication, which spares the lung but removes the diseased pleural lining and other impacted tissue.
Following the surgery they were also all provided with pleural lavage, a process in which heated povidone iodine was used to rinse out the surgical site. This solution is frequently used as a surgical disinfectant, and studies have shown that it may have the ability to kill cancer cells left behind after surgery.
All of the patients in the survey were also provided with both radiation therapy and chemotherapy, though there were differences in whether those treatments were provided pre or post surgically. In all 102 cases, the patients all had a 30-day survival, with approximately one in three experiencing some form of complication in the aftermath of their surgery.
Remarkably, a follow up on the patients at the five year mark revealed that almost 25% were still alive, a statistic that goes well beyond expectations. Because mesothelioma is an aggressive cancer that is generally not identified until it has already reached an advanced stage, most patients die within one year of diagnosis, but in this group of patients who all submitted to multiple modality therapies, the median survival rate was two years and eight months.
Those who had been identified with epithelioid mesothelioma had an even more encouraging median survival of just shy of three years, and almost one third were still alive at the five year mark.
Though physicians still feel that they need more research as to whether to provide chemotherapy and radiation therapy before or after surgery, they are encouraged by this study’s results.
