Italian researchers describe long-term survival after tri-model mesothelioma treatment
A Peruvian woman diagnosed with pleural mesothelioma has been free of disease for four years, more evidence that a “tri-modal” strategy of surgery, chemotherapy and radiation can be a successful approach to treating the rare but deadly disease.
In the April, 2012 issue of the journal Anticancer Research, Italian researchers report the 26-year-old woman patient underwent two cycles of chemotherapy with pemetrexed and cisplatin, followed by an extra-pleural pneumonectomy (EPP), an aggressive surgery that removes the mesothelioma tumor and the lining of the lung where the tumor is located.
After 6 months, the patient was treated with three-dimensional external beam radiation therapy, an advanced, computer-controlled technique that results in less damage to adjacent tissue and nearby organs. The researchers report that, four years later, computed tomographic scans showed no cancerous cells and the woman is in good health.
Pleural mesothelioma is the most common form of the disease, which spreads across the thin membranes that encase internal organs. In most cases, the prognosis is poor, with most patients dying within 18 months of diagnosis.
More careful management of the tri-modal regimen by clinicians has led to improved outcomes for some mesothelioma cases, especially in younger patients. The surgical techniques — EPP or pleurectomy/decortication, a less-invasive operation involving removal of the lung lining while preserving the lung and other tissue — “debulk” the tumor mass. The patient then undergoes chemotherapy, followed by radiation. Ongoing studies are helping clinicians better understand chemotherapy and radiation dosages and techniques that have the best impact on survival.
The Italian researchers say the case shows that a “good staging system and a combined treatment involving surgery, neoadjuvant chemotherapy and adjuvant radiation therapy represents a useful strategy not only to contain local disease progression, but even to increase disease-free survival in pleural mesothelioma.”