Malignant mesothelioma is caused by exposure to asbestos, a naturally occurring mineral that was used extensively throughout the 20th century in a number of military and industrial applications. This type of cancer develops in the mesothelial cells that make up the lining of the lungs, heart and abdomen. Symptoms typically take anywhere from 20 to 50 years to become noticeable, so the cancer is often diagnosed in advanced stages when treatment options are limited. If the disease is caught early enough, several forms of treatment can be used to fight the cancer, known as multimodality therapy.
A recently published study in the Journal of Thoracic Oncology says that using treatment planning techniques such as intensity modulated radiotherapy (IMRT) could be helpful for malignant pleural mesothelioma patients.
A multimodality therapy approach involving a surgical procedure known as an extrapleural pneumonectomy (EPP), chemotherapy and radiotherapy is often suggested for patients diagnosed during the early stages of pleural mesothelioma. However, setting up radiotherapy treatment after EPP can be difficult due to the large target area, the high doses necessary to prevent recurrence and the proximity of vital organs and other important structures.
V. Gupta and colleagues examined the local and nodal (lymph nodes) recurrence in patients treated with EPP and radiation therapy to establish whether IMRT could be used as a treatment method.
The study included 86 patients with malignant pleural mesothelioma who had undergone radiotherapy and an EPP. The radiotherapy technique included a combination of photons and electrons to maximize the dosage to the targeted area.
The results of the study showed that only 10 percent of patients developed late grade three pulmonary toxicity and no patients passed away. V. Gupta and colleagues concluded, “IMRT’s advantages must be balanced against the increased risk of fatal pulmonary toxicity.”
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