According to Italian research, an aggressive dose of advanced radiotherapy (radical Hemi-thoracic radiotherapy) can double the survival time of malignant pleural mesothelioma patients.

Advanced and high dosage of radiotherapy at the affected location can increase the survival rate of patients of malignant mesothelioma by two years or more, according to new research presented at ESTRO 38 (European Society for Radiotherapy and Oncology).

Precise and focused use of radiotherapy to kill the cancerous cells and to stop further spread of tumor started back in the 1960s. Lars Leksell used it in the 1960s. Later in the 1990s, with the development of MRI, the visualization of the tumor became much more accessible. In this time, doctors performed radiotherapy on lung cancer patients and the doctors throughout the process made further developments in the treatment of the disease. The most significant event was the initiation of stereotactic body radiotherapy- SBRT. Later SBRT was implemented on various other cancers, including renal tumors, spine cancers, prostate cancers, and several others.

Doctors are now using radiotherapy as one of the first treatments performed on malignant mesothelioma patients. Though the efficacy and the resultant increase in the survival time with this treatment has remained doubtful in the past, this current research presented by the Italian researchers has renewed optimism on this technique.

Excessive and regular exposure to asbestos causes mesothelioma. It is a rare yet immensely aggressive type of cancer that spreads in the thoracic cavity around the lungs.

In recent years, technological advancements and a wide range of scientific research have devised various improvements in the technique of radiotherapy.

In the presented research, the researchers have used this advanced technique with a high dosage to gain more survival time for malignant pleural mesothelioma patients. And the results deduced with this experiment are highly optimistic.

Experts discussed this study at the most recent conference held by ESTRO- European Society for Radiotherapy and Oncology on 26 to 30th April 2019. The underlying theme of this year's conference was "Targeting optimal Care, together."

Study Design with Targeted Increased Radiotherapy Dosage

The study led by Professor Dr. Marco Trovo MD, chief of the Radiation Oncology Department at University Hospital of Udine, Italy. Dr. Trovo and his colleagues aimed their research to improve the survival time of patients suffering from malignant pleural mesothelioma by using an advanced form of radiotherapy. Doctors use this therapy to target the tumor directly at the tumors diagnosed location. Specifically targeted and aggressive radiation can significantly improve the malignancy of cancer and elevate the chances of increased survival time.

With several developments and advancements in radiotherapy, the use of radiation in an aggressive and localized manner can bring the hope of a speedy cure for cancer patients.

Dr. Marco Trovo says,

"There is an urgent need for more effective treatments for mesothelioma. Surgery can be performed on these patients, but it is often impossible to remove all of the tumors. Patients with mesothelioma are sometimes given radiotherapy to help control their symptoms. However, radiotherapy has evolved dramatically in the last few years so we wanted to see if it could now be used to prevent cancer from spreading to nearby tissue, hopefully bringing improvements in survival."

Researchers designed the study with 108 malignant pleural mesothelioma patients who were treated between the period of 2014 to 2018 at the National Cancer Institute of Aviano, Italy. All of these patients underwent chemotherapy, and surgical treatments to remove cancerous tissues.  But the tumor of these patients was not wholly removed with surgical procedures performed in that period.

Next, half of these patients were randomly selected to be given an aggressive dose of radiotherapy, while the other half received standard radiotherapy. For the former doctors performed radical Hemi-thoracic radiotherapy in which radiation was explicitly targeted at the location of the tumor, delivering 25 treatments with a total dosage of 50 Gy on the right or left side and another 60 Gy on the precise tumor location.

The other group was given 5 to 10 treatments of total 20 to 30 Gy dosage at the tumor location.

Significantly Improved Survival with Minor Side Effects

The difference between the results of both groups was very significant. The patients who received aggressive radiation treatment lived for a considerably more extended period than those who received conventional palliative radiotherapy treatment.

58% of the patients who received a high dose of radiotherapy treatment are still alive after two years of treatment. And only 28% of the patients in the other group lived that long.

Regarding, the side effects of the radical hemi-thoracic radiotherapy, about 20% of the patients who received this treatment suffered through the inflammation of lung- pneumonitis. Whereas, other milder side effects of this treatment include nausea, weakness, and swelling of the esophagus.

Dr. Marco Trovo believed that these results and findings are a significant breakthrough to significantly improve the survival time of malignant pleural mesothelioma patients by using already in-hand techniques. By changing the protocol and intensity of radiotherapy, extraordinary results are possible.

He says that,

"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. We believe that this should be considered a new standard of care for these patients."

Future Prospects and Beneficial Aspects of the Research in Clinical Treatment

Head of Oncology Department at the University of Turin, Italy, and the President of ESTRO, Professor Umberto Recardi presented highly appreciative comments on this research saying,

"This is an extremely positive result that brings good news to patients with this rare and difficult-to-treat cancer. To ensure these patients benefit from this type of treatment, it's important that they are referred to a specialist cancer center with the right expertise and equipment to carefully plan and deliver the most effective radiotherapy treatment, and manage any side effects that occur."

Dr. Marco Trovo has high hopes that this treatment can be more helpful after treating patients with immunotherapy. As in immunotherapy, the body's immune system is prepared to fight against the spreading of cancer cells. Thus, the body is already set to kill the tumor and stop further metastasis, and aggressive radiotherapy can boost this process exponentially.

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