Analysis of the effect of radiotherapy on malignant pleural mesothelioma when given on adjuvant or palliative basis

Our plain-English summary of Analysis of the effect of radiotherapy on malignant pleural mesothelioma when given on adjuvant or palliative basis, by H.A. El Hossieny, F. Aboulkasem, M. Abdel Rahman (Zhongguo Fei Ai Za Zhi = Chinese Journal of Lung Cancer, 2010).

The study

• Authors: H.A. El Hossieny, F. Aboulkasem, M. Abdel Rahman
• Journal: Zhongguo Fei Ai Za Zhi = Chinese Journal of Lung Cancer
• Published: 2010;13(1):54-9
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background And Objective: This retrospective study was designed to evaluate the response and survival of malignant pleural mesothelioma to radiotherapy when delivered with surgery and chemotherapy and when delivered alone or with chemotherapy.

Methods: A study for 110 patients with malignant pleural mesothelioma who presented to radiotherapy department, National Cancer Institute, Cairo and received radiation therapy in the period fromJanuary 1999 to July 2007.

Results: Forty-six patients (41.8%) received trimodality therapy (surgery & adjuvant or neoadjuvant chemotherapy & adjuvant radiotherapy), while bimodality therapy (chemotherapy & radiotherapy) in 38 patients (34.5%), while 26 patients (23.6%) received single modality therapy (palliative radiotherapy), 22 patients (20%) developed local recurrence, 22 patients (20%) developed distant metastases months, 14 patients (12.7%) developed local disease progression, 25 patients (22.7%) are still alive and free of disease at time of reporting. The median survival for all patients was 16 months, while 12 and 18 months overall survival were 63.6% & 31.8% respectively while median survival for stage II, III, IV patients was 16.5, 12.5 and 8 months respectively.

Conclusion: Multimodality approach involving surgery, chemotherapy and radiotherapy have been evaluated and proved its superiority in improving survival, especially in stages II.

In plain English

This retrospective study reviewed the files of 110 patients with malignant pleural mesothelioma who received radiotherapy at the National Cancer Institute in Cairo, Egypt, between January 1999 and July 2007. Of these patients, 95 (86%) lived in endemic areas around asbestos factories. The article did not name fiber types for these patients. Treatment depended on stage and performance status. Forty-six patients received surgery, chemotherapy and radiotherapy, 38 received chemotherapy and radiotherapy, and 26 received palliative radiotherapy alone. Median survival for all patients was 16 months. Overall survival was 63.6% at 12 months and 31.8% at 18 months. Median survival was 16.5, 12.5 and 8 months for stages II, III and IV, a statistically significant difference. Median survival by treatment group was 16, 11 and 8 months; no statistical test was reported for this comparison. Of the 26 patients given radiotherapy alone, 15 (57.7%) had improved chest pain. Twenty-five patients (22.7%) were alive and free of disease at reporting. The authors concluded that combined surgery, chemotherapy and radiotherapy improved survival, especially in stage II, but that survival rates remained low.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective review of patient files (case series) of patients treated with radiotherapy
• Who was studied: 110 patients with malignant pleural mesothelioma who received radiation therapy at the radiotherapy department, National Cancer Institute, Cairo, Egypt, January 1999 to July 2007. They were aged 29 to 73 (median 49); 70 were male and 40 female. By stage, 60 were stage II, 30 stage III and 20 stage IV.
• Exposure: The exposure studied was radiotherapy given in three treatment schemes: 46 patients had trimodality therapy (surgery, chemotherapy and adjuvant radiotherapy of 50 Gy in 25 fractions), 38 had chemotherapy plus radiotherapy, and 26 had palliative radiotherapy alone. Asbestos exposure was described only as residence in endemic areas around asbestos factories (95 patients); no fiber type was given for these patients.
• Main results:
  • 95 of the 110 patients (86%) lived in endemic areas around asbestos factories; 75 (68%) were smokers and 32 (29%) were industrial workers.
  • Treatment was chosen according to stage and performance status. Patients with operable, early-stage disease and good performance were offered trimodality treatment.
  • Median survival for all 110 patients was 16 months.
  • For all patients, overall survival was 63.6% at 12 months and 31.8% at 18 months.
  • Median survival by stage was 16.5 months (stage II), 12.5 months (stage III) and 8.0 months (stage IV), with P=0.000 12.
  • 18-month overall survival was 41.6% for stage II, 33.3% for stage III and 0% for stage IV, reported as statistically significant.
  • Median survival by subtype was 17 months for epithelioid and 13 months for biphasic and sarcomatoid combined. With P=0.36, the difference was not statistically significant.
  • Median survival by treatment group was 16 months for trimodality, 11 months for bimodality (chemotherapy plus radiotherapy) and 8 months for palliative radiotherapy alone. No P value was given for this comparison.
  • Among the 26 patients who received radiotherapy only, 15 (57.7%) had improved chest pain.
  • 22 patients (20%) developed local recurrence after an average of 8 months, and 22 patients (20%) developed distant metastases after an average of 7 months.
  • 25 patients (22.7%) were alive and free of disease at the time of reporting. Of these, 23 had undergone extrapleural pneumonectomy and 23 were stage II.
• The authors' conclusion: The authors concluded that a multimodality approach of surgery, chemotherapy and radiotherapy proved superior in improving survival, especially in stage II. They added that survival rates were still low and that newer treatment strategies need to be explored.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Palliative Care, Chemotherapy, Trimodality Therapy, Neoadjuvant Chemotherapy, Disease Progression, Median Survival, Overall Survival.

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