Pleural mesothelioma treated by fast neutron therapy

Our plain-English summary of Pleural mesothelioma treated by fast neutron therapy, by P.R. Blake, M. Catterall, P.A. Emerson (Thorax, 1985).

The study

• Authors: P.R. Blake, M. Catterall, P.A. Emerson
• Journal: Thorax
• Published: 1985;40(1):72-3
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

The authors reported a single patient with malignant pleural mesothelioma treated with fast neutron therapy at the Medical Research Council Cyclotron Unit, Hammersmith Hospital, London. A 56 year old housewife presented in January 1976 with a persistent cough and a small pleural effusion. Pleural biopsy and bronchoscopy showed no malignancy. In April 1977 a subcutaneous mass appeared at the biopsy site, and its excision showed malignant mesothelioma, confirmed by electron microscopy. By July 1977 there was further local recurrence, and computed tomography showed a 45 x 50 mm left paravertebral mass. She had no history of asbestos exposure, and there was no evidence of distant metastases. In July and August 1977 she received 1650 cGy of fast neutrons in 12 fractions over 35 days. Over the next four months the subcutaneous mass regressed completely. A 10 x 10 mm nodule that grew next to the treated area in March 1978 regressed after cobalt radiation. The effusion needed five aspirations and then did not recur. At 78 months after treatment there was no sign of recurrent disease. The authors noted that the low energy of the Hammersmith neutron beam limited treatment to thin patients with limited disease. They concluded that the long disease free survival was encouraging. They suggested that higher energy cyclotrons could allow radical treatment of larger or deeper mesotheliomas and comparison with x ray treatment.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This short report described one patient with malignant mesothelioma of the pleura who was treated with fast neutron therapy at the Medical Research Council Cyclotron Unit, Hammersmith Hospital, London. The patient, a 56 year old housewife, first saw a doctor in January 1976 with a persistent cough and a small pleural effusion. In 1977 a mass at the pleural biopsy site was found to be malignant mesothelioma, and scans showed a 45 x 50 mm mass in the left chest beside the spine. The article stated that the patient had no history of exposure to asbestos fibre. In July and August 1977 the patient received 1650 cGy of neutron therapy in 12 fractions over 35 days. The mass under the skin regressed completely within four months. A small new nodule that appeared in March 1978 regressed after cobalt radiation. The authors reported no sign of recurrent disease 78 months after treatment and called the result encouraging. They noted that the patient was unusual and that their neutron beam penetrated tissue poorly. As a report on one person, it describes this case 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)
• Who was studied: One 56 year old housewife with malignant pleural mesothelioma, first seen in January 1976 and treated at the Fast Neutron Clinic, MRC Cyclotron Unit, Hammersmith Hospital, London, in 1977
• Exposure: The article reports no asbestos exposure: the patient had no history of exposure to asbestos fibre. The treatment reported was fast neutron therapy, 1650 cGy (rad) in 12 fractions over 35 days, using a three field technique.
• Main results:
  • In this patient, malignant mesothelioma was diagnosed in a subcutaneous mass at the pleural biopsy site and confirmed by electron microscopy. Scans showed a 45 x 50 mm mass in the left paravertebral region.
  • In this patient, the subcutaneous mass regressed completely over the four months after neutron therapy.
  • In March 1978 a 10 x 10 mm nodule grew next to the lower border of the treated area. It regressed after 4900 cGy of cobalt radiation in 12 fractions over 27 days.
  • The patient's pleural effusion at first increased and needed five aspirations, then did not recur. Since April 1978 only a small unchanged left basal opacity remained.
  • In this patient there was no sign of recurrent disease 78 months after treatment.
• The authors' conclusion: The authors concluded that the visible regression and the long disease free survival after neutron therapy in this patient were encouraging. They wrote that higher energy neutron beams should make it possible to treat larger or deeper mesotheliomas and to compare fast neutrons with x ray treatment.
• Limitations the authors state:
  • The authors noted that the patient was unusual in presenting with a bulky mass localised to half the pleural cavity, whereas most patients present with advanced disease.
  • The authors noted that the Hammersmith neutron beam was of comparatively low energy and had poor tissue penetration.
  • The authors stated that an adequate dose to tumours of the mediastinal pleura could be delivered only in thin patients with limited disease.

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, Pleural Effusion, Pleural Biopsy, Bronchoscopy, Biopsy, Malignant Mesothelioma, Asbestos Exposure, Mesothelioma.

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