It has been well established that the most effective treatment for malignant mesothelioma is a multi-modality approach that attacks the disease in numerous ways. The challenge for researchers and physicians has been to identify the most effective combination that delivers safety and extended survival. A recent study conducted by researchers at the Princess Margaret Cancer Centre at the University of Toronto in Canada indicates that good early and long-term results can be derived from combining a short, accelerated course of high-dose radiotherapy followed by extrapleural pneumonectomy. The protocol is referred to as the SMART protocol.
SMART Protocol Combines Radiation and Surgery
Malignant pleural mesothelioma is an aggressive form of cancer that forms in the thoracic cavity and affects the pleura, as well as surrounding organs and tissue. It has proven extremely resistant to traditional oncology treatment. The researchers from the Princess Margaret Cancer Centre studied a protocol called SMART (Surgery for Mesothelioma After RadioTherapy) to assess how patients tolerate the approach and what kind of long-term impact it delivers.
The researchers assessed outcomes from a total of 102 patients treated for malignant pleural mesothelioma between November of 2008 and October of 2019. The patients all had untreated disease and were determined to be eligible for surgery. Each received radiation therapy over their entire thoracic region in five daily doses over a one-week period, followed by an additional boost to their high-risk area. They then submitted to extrapleural pneumonectomy, an aggressive surgery involving removal of a lung, a portion of the diaphragm, and the linings of the lungs and heart (parietal pleura and pericardium). Some patients were also provided with chemotherapy.
Study Shows Promising Results for SMART Mesothelioma Treatment
Though one mesothelioma patient died of pneumonia within 30 days of the surgery and 47 had adverse effects within 30 days of the surgery, follow-up shows that the 5-year cumulative incidence of cancer returning was 63.3 percent, with the most common site of recurrence in the chest. Based on these findings the researchers concluded that the protocol delivered good early and long-term results, though more work is needed to help patients survive the initial post-operative period.
If you or someone you love has been diagnosed with malignant mesothelioma, you need information on where to find state-of-the-art medical care and other resources. The Patient Advocates at Mesothelioma.net can help. Call us today at 1-800-692-8608.