Though most patients diagnosed with malignant mesothelioma are treated using a multimodality treatment combining surgery, chemotherapy, and radiation therapy, it has long been accepted that radiation therapy provides the least benefit of the three. Though the tool can effectively kill cells, its lack of precision has made it unwieldy when treating the challenging landscape of a mesothelioma tumor, and as a result it has been used more frequently to alleviate symptoms than to effect any type of cure, or even to prolong survival time. But according to a new study conducted by researchers from the University of Pennsylvania’s Perelman School of Medicine, improvements in technological precision and new radiotherapy tools may mean that the protocol will have an expanded and more beneficial use in the future.
Writing in the Journal of Thoracic Disease, Penn’s mesothelioma researchers suggest that with the use of new tools such as intensity modulated radiotherapy (IMRT), sterotactic body radiotherapy (SMRT), and proton-based radiotherapy, radiation will be able to better support the effects of surgery and immunotherapy in treating the rare and fatal form of cancer. Where previous tools have spread radiation across too wide a swath of the body, killing surrounding healthy tissue, the newer, highly targeted iterations of radiation tools are able to accomplish the goal of interrupting cancer cell life cycles, even in an irregularly shaped tumor such as is found in pleural mesothelioma. This possibility brings the hope of a cure closer to being a reality.
When mesothelioma patients are diagnosed and their disease is staged, one of the first things that their physicians examine is the exact position of the tumor itself: because mesothelioma grows in a thin layer rather than into a dense tumor, it has traditionally been more difficult to irradiate without damaging important nearby organs such as the lungs and the heart. The new tools are much more precise, and can be used both to shrink tumors before surgery as well as to keep them from growing back. According to lead study author Gwendolyn Cramer, a radiation oncologist, “Further improvements in the technological sophistication of the apparatus, planning systems and techniques for RT delivery along with clinical innovation will continue to afford new uses of RT in the management of patients with malignant pleural mesothelioma.”
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