Aggressive radiotherapy doubles survival for mesothelioma patients

Patients with the rare, but aggressive form of cancer—mesothelioma—are twice as likely to survive for two years or more if treated with a high dose of radiotherapy, according to research presented at the European Society for Radiotherapy and Oncology (ESTRO) 38 conference in Milan, Italy.

Mesothelioma grows in the tissue surrounding the lungs and those who develop it usually only live for one or two years as treatment options are very limited, according to lead researcher Marco Trovo, MD, chief of the radiation oncology department at University Hospital of Udine, Italy.

"There is an urgent need for more effective treatments for mesothelioma. Surgery can be given to these patients, but it is often impossible to remove all of the tumor,” Trovo said in a news release.

"Patients with mesothelioma are sometimes given radiotherapy to help control their symptoms,” Trovo added. “However, radiotherapy has evolved dramatically in the last few years so we wanted to see if it could now be used to prevent the cancer from spreading to nearby tissue, hopefully bringing improvements in survival."

To test radiotherapy’s impact, the team enrolled 108 patients with malignant pleural mesothelioma who underwent surgery to remove tumor tissue followed by subsequent chemotherapy at the National Cancer Center Institute of Aviano, Italy.

Fifty percent were randomized to receive radical hemi-thoracic radiotherapy, which delivers radiation to the cancerous side of the torso. Patients received 25 treatments for a total dosage of 50 Gy followed by an additional 60 Gy dose to the exact tumor location. The other half of patients received 5-10 treatments, totaling 20-30 Gys delivered to the precise location of the tumor.

Fifty-eight percent of those who received aggressive radiotherapy were alive two years later. In comparison, a total of 28% of patients who received the palliative treatment were alive at that same follow-up.

Trovo and colleagues noted that 20% of patients in the radical hemi-thoracic radiotherapy group experienced radiation pneumonitis. But overall, the results are a positive sign for mesothelioma patients.

"This research shows a clear survival benefit in using this type of radiotherapy for mesothelioma patients whose tumors can only partially be removed by surgery,” Trovo said in the same release. “We believe that this should be considered the new standard of care for these patients."