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Mesothelioma Triple Therapy Found Safe and Effective An

By Carmen Chavez,2014-06-26 20:44
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Mesothelioma Triple Therapy Found Safe and Effective An ...

Mesothelioma Triple Therapy Found Safe and Effective

An aggressive treatment strategy that begins with chemotherapy, followed

    by surgery, and then radiation is a safe and effective option for many

    mesothelioma patients, according to a recent study in The Annals of

    Thoracic Surgery.

Mesothelioma traditionally hasn‟t responded well to just one treatment

    (surgery, chemotherapy, or radiation). In the early 1990s, Dr. David

    Sugarbaker of the Brigham and Women‟s Hospital in Boston reported on

    the use of combining therapies. When he treated mesothelioma patients

    with extrapleural pneumonectomy (EPPsurgery to remove the diseased

    lung, as well as the diaphragm and the membrane covering the heart and

    lung), followed by chemotherapy and radiation, the results were promising.

Researchers at the Swedish Cancer Institute in Seattle, Washington, tried

    to replicate this triple-treatment approach, but they found it difficult to

    deliver chemotherapy after EPP. “Historically when giving chemotherapy

    after cancer surgery, we like to start doing it within 60 days, at the latest, of

    the surgery date,” explains Eric Vallières, MD, FRCSC, Surgical Director of

    the Swedish Cancer Institute‟s Lung Cancer Program. “The problem with

    starting chemotherapy too „early,‟ i.e., before full patient recovery, is that

    the chemo is too hard on them and they just quit.”

Instead of delivering chemotherapy after mesothelioma surgery, Dr.

    Vallières and his team decided to study the effectiveness and safety of

    beginning the treatment with chemotherapy, followed by surgery and then

    radiation. The reported study included 55 patients who were treated for

    mesothelioma between 1997 and 2008.

First, the mesothelioma patients received up to four cycles of

    chemotherapy (most often a combination of cisplatin and pemetrexed). A

    few weeks later, patients who were healthy enough had a diagnostic

    procedure to determine whether they were good candidates for surgery (if

    the cancer had not spread). A total of 38 patients underwent the entire

    treatmentinduction chemotherapy, then EPP, followed by either external beam radiotherapy (EBRT) or intensity-modulated radiotherapy (IMRT) six

    to eight weeks later.

    Generated on 10/9/2009 7:28:23 PM, by iNews Publisher, Expinion.net

    Overall, mesothelioma patients who completed chemotherapy, surgery, and radiation survived an average of two years. Patients who received IMRT appear to have a lower risk of cancer recurrence (14.3%) compared with the EBRT group (41.7%). According to the authors, one of the potential advantages of using IMRT is to better target the cancer while sparing nearby organs from radiation exposure.

    Based on the results of this study, chemotherapy followed by EPP and radiation seems to be a safe and effective choice for mesothelioma patients. “Our results are definitely good enough for us to continue favoring an induction approach for most of our patients,” Dr. Vallières

    says.However, mesothelioma treatments still have a long way to go before they can provide patients with a more favorable outlook. “Personally, I think that we have plateaued, and will maintain the same results until we have better systemic therapy,” according to Dr. Vallières. He says improved chemotherapy or new biologic treatments are needed to improve survival rates.

 

Source:

    Buduhan G, Menon S, Aye R, Louie B, Mehta V, Vallières E. Trimodality therapy for malignant pleural mesothelioma. The Annals of Thoracic Surgery. 2009;88:870-876.

     ? Surviving Mesothelioma and Cancer Monthly.  All rights reserved.  More Mesothelioma News

    Generated on 10/9/2009 7:28:23 PM, by iNews Publisher, Expinion.net

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