Surgery After Radiotherapy Offers Significant Improvement in Mesothelioma Survival
One of the most devastating aspects of malignant pleural mesothelioma is the speed with which the disease overtakes its victims. Scientists searching for a way to slow the process and extend survival have been optimistic about a treatment known as SMART, or surgery for malignant mesothelioma after radiotherapy. A report just published in the journal Lancet Oncology details the results of a study in which patients undergoing SMART and extrapleural pneumonectomy were able to realize median overall survival of 24.4 months with 18 months of disease-free survival: Patients with the epithelial type of the disease saw median overall survival of 42.8 months.
SMART Study Involved 96 Patients with Malignant Pleural Mesothelioma
The mesothelioma research was conducted at the Princess Margaret Cancer Centre in Toronto, Canada, and it included 96 patients treated between November 2, 2008 and October 31, 2019. Notably, each of the patients had respiratory function strong enough to withstand the highly aggressive extrapleural pneumonectomy procedure, which removes the diseased part of the lung.
Each patient was dosed with radiation in 5 days over one week to the entire side of the chest affected by mesothelioma, along with additional doses to high-risk areas of the body. The surgery was performed within seven days. Some patients were also provided chemotherapy to treat cancer that had spread to their lymph nodes.
Main Concern was Toxicity of Treatment for Mesothelioma Patients
The researchers explained that their study’s main focus was on deaths or side effects of the treatment protocol, though they also examined overall survival, disease-free survival, and other factors. They pointed out that the key to success in this treatment approach lies in evaluating patients to ensure that they are suitable candidates, as the high risk of complications can affect long-term survival after treatment. Each patient was followed for five years following the protocol, with the researchers finding that almost half had some kind of side effect within 30 days after surgery. One died of pneumonia within that time period.
Authors Conclude SMART Is Effective for Certain Mesothelioma Patients
In assessing their outcomes, the authors said that the IMRT was well tolerated and that 63.3% of patients had a distant recurrence by the five-year point. Median overall survival was 24.4 months with an 18-month disease free survival, leading them to conclude that the approach can be done with good early and long-term results, especially if complications can be minimized in the period immediately after the surgery.
If you or someone you love has been diagnosed with malignant pleural mesothelioma and you would like more information about treatment options, the Patient Advocates at Mesothelioma.net can help. Contact us today at 1-800-692-8608.
Written by Terri Oppenheimer
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