Double cancer comprising malignant pleural mesothelioma and squamous cell carcinoma of the lung treated with radiotherapy: A case report

Our plain-English summary of Double cancer comprising malignant pleural mesothelioma and squamous cell carcinoma of the lung treated with radiotherapy: A case report, by Y. Negi, K. Kuribayashi, H. Doi, et al (Molecular and Clinical Oncology, 2018).

The study

• Authors: Y. Negi, K. Kuribayashi, H. Doi, N. Funaguchi, Y. Koda, E. Fujimoto, K. Mikami, T. Minami, T. Yokoi, T. Kijima
• Journal: Molecular and Clinical Oncology
• Published: 2018;9(2):181-186
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Pleurectomy/decortication (P/D) is the surgical treatment of choice for early malignant mesothelioma, but it remains unclear whether radiotherapy along with P/D should be used as multimodal treatment for this disease. We herein present the case of a 76-year-old man with a history of asbestos exposure who was diagnosed with left-sided malignant pleural mesothelioma in February 2010. The patient underwent chemotherapy with a combination of cisplatin and pemetrexed and achieved stable disease, after which time he was kept under observation. A positron emission tomography/computed tomography scan performed in February 2011 revealed nodular shadows with fluorodeoxyglucose uptake in S3 of the left lung; using bronchoscopy, the patient was diagnosed with stage IIB (cT3N0M0) primary squamous cell carcinoma. Chemoradiotherapy with vinorelbine and 60 Gy/20 fr radiotherapy was performed, and a partial response was obtained, suggesting that the radiotherapy used to treat the carcinoma of the lung may have also helped control the disease activity of the pre-existing mesothelioma. The present case indicates the value of radiotherapy in the treatment of malignant mesothelioma. The aim of the present study was to examine the possibility of new multimodal treatments for mesothelioma, along with a discussion of the relevant literature.

In plain English

This article was a case report about one man in Japan who had two cancers at the same time: malignant pleural mesothelioma and squamous cell carcinoma of the lung. He had worked at a cement factory and was exposed to asbestos from age 25 to 40. The article did not name the fiber type. He also had pulmonary asbestosis. Left-sided mesothelioma was diagnosed in February 2010 at stage 1A. His lung function was impaired, so he was not a candidate for extrapleural pneumonectomy. He received cisplatin plus pemetrexed instead, and after four courses his disease was stable. In 2011, squamous cell lung cancer was found in the left lung and treated with vinorelbine and radiotherapy (60 Gy in 20 fractions). That tumor was well controlled, but he developed grade II radiation pneumonitis. A second lung squamous cell cancer was found later in 2011, and he died of lung cancer in November 2013. The authors suggested that the radiotherapy given for the lung cancer may also have helped control the mesothelioma. The report describes one patient only.

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: case report (single patient) with a discussion of the literature
• Who was studied: One man, 75 years old according to the article text, with a history of early gastric cancer, seen at the asbestos center of the authors' hospital in Hyogo, Japan, from November 2005 onward
• Exposure: Occupational asbestos exposure while employed at a cement factory, from age 25 to 40. The fiber type is not stated.
• Main results:
  • The patient was diagnosed with left malignant pleural mesothelioma, cT1aN0M0, stage 1A, after a pleural biopsy in February 2010.
  • Extrapleural pneumonectomy was not possible because of impaired lung function from pulmonary asbestosis and chronic obstructive pulmonary disease.
  • After four courses of cisplatin plus pemetrexed, the left pleural effusion improved and the mesothelioma was stable.
  • In 2011, squamous cell carcinoma of the left lung (S3) was diagnosed by bronchoscopy, stage IIA according to the article text.
  • The lung cancer was treated with vinorelbine plus radiotherapy of 60 Gy in 20 fractions (3 Gy per fraction).
  • The treated lung tumor was well controlled, but the patient developed grade II radiation pneumonitis.
  • A new lung squamous cell carcinoma in the left S8 was diagnosed in November 2011 and was considered a second primary cancer. It worsened on docetaxel, and the patient was then given gemcitabine.
  • The patient died of lung cancer in November 2013.
• The authors' conclusion: The authors concluded that the radiotherapy given for the lung cancer may also have locally controlled the pre-existing mesothelioma, though only as a side effect. They suggested there are grounds to consider radiotherapy to the conserved lung after pleurectomy/decortication, which is not currently done in Japan.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Squamous Cell Carcinoma, Pleurectomy/Decortication (P/D), Malignant Mesothelioma, Asbestos Exposure, Chemotherapy, Cisplatin, Pemetrexed (Alimta).

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