Pleural mesothelioma patients who underwent lung-sparing surgery in combination with photodynamic therapy (PDT) showed superior overall survival than patients treated with conventional therapy using extrapleural pneumonectomy (EPP) (en bloc or the removal of the lungs and surrounding tissue) with PDT , suggests new research from the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania. The research is published in the June 2011 issue of Annals of Thoracic Surgery.
"Unlike the lungs of patients who received traditional sacrificing surgery for mesothelioma, patients in our study who underwent lung sparing surgery and photodynamic therapy, light-based cancer treatment, has undergone a remarkable degree the length of overall survival. The survival of the average average for patients has not reached more than two years when the results were analyzed. That's unusual in this field, especially when the majority of those patients who were older and had advanced cancer, "said Joseph Friedberg, MD, co-director of Penn and Program pleural mesothelioma and the Doctor thoracic surgeon who performed the operation cited in the study. "In addition to overall survival statistics, the difference between having and not having lungs, either with respect to the risks of surgery and the ability to enjoy a normal life after surgery, it is important for these patients."
Mesothelioma is one of the most aggressive and lethal of cancers and is usually caused by exposure to asbestos. Exposure to asbestos is usually precedes the development of cancer by anywhere from 10-50 years, but after that happened, the average survival following diagnosis is often only 9-12 months.
Although mesothelioma can occur in other locations such as the abdomen, pleural mesothelioma is the most common form of the disease and accounts for about 70 percent of cases. This form originated in the pleura - the membrane that surrounds the lungs and lining the chest - which begins as a microscopic sheet of malignant cells that line the inside of the chest and can grow to several inches thick. Layer and surrounding properties is not possible to remove the cancer with surgery alone. As a result, the conventional approach to treatment based operations involve radical surgery that included removing the lungs, in combination with chemotherapy and radiation throughout the breast. Even with aggressive treatment, the disease will recur in almost all patients.
The current study has two objectives. The first is to determine whether using a novel combination of PDT and surgery will allow less extensive surgical procedure to be used in lieu of the EPP. The second is to determine whether, based on previous research from Penn with PDT, the treatment will have a positive effect on survival for patients.
Unlike radiation, which passes through the body, PDT therapy is used in this study only penetrate a short distance that allows the lungs to be maintained. PDT treatment aims to eradicate the remaining microscopic disease trigger the patient's immune system to help fight cancer. Penn is one of only two centers in the world where PDT is used to treat pleural mesothelioma.
In the study, 28 patients (19 men, 9 women) underwent surgical resection plus PDT for pleural mesothelioma. Patients aged 27-81 years. All patients seen in a multidisciplinary setting and educated about the spectrum of available treatment options, including surgical intervention and its status is currently under study. Of the study group, 14 patients treated by extrapleural pneumonectomy modified (MEPP) and 14 by radical pleurectomy (RP) and intraoperative PDT. Twenty-two of 28 patients also received chemotherapy.
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