Mesothelioma Radiation Therapy
Mesothelioma patients often undergo radiation, which focuses x-ray beams on cells, killing them. Sometimes, it is used with chemotherapy. The treatment has been used for years, but radiation has improved tremendously over the past 10, especially for pleural and peritoneal patients. These advancements have proven necessary because current radiation therapy techniques have a 50-percent success rate after 24 months. About 30 percent of patients see a recurrence in mesothelioma.
Such advancements include intensity-modulated radiation therapy (IMRT), a form of three-dimensional radio therapy that improves the delivery of the rays. Unlike conventional radiation techniques, which deliver large doses of radiation, IMRT uses a computer-aided system and three-dimensional maps designed from a CT scan. With this map, radiologists and oncologists can better target x-rays and avoid healthy organs and glands. This is important because traditional radiation therapy can harm normal cells as well as cancerous ones.
Although finding other treatments to increase the 50-percent success rate has proven to be a challenge, oncologists and radiologists are working to develop them, focusing on adjusting the intensity and volume of radiation. While high doses of radiation are generally more effective, they can cause life-threatening side effects, such as pneumonitis, or lung inflammation.
Intesnity Modulated Radiation Therapy
Currently, the M.D. Anderson Cancer Center at the University of Texas in Houston and the Dana-Farber Cancer Institute in Boston are on the cutting edge of developing better radiation methods, particularly IMRT. For years, combining surgery, radiation, and chemotherapy has been the standard treatment for mesothelioma patients. However, with continued research and practice, IMRT could become the new one.
At this point, it's being used alongside chemotherapy medications and following extrapleural pneumonectomies (EPP) and radical resectionings. (In EPP, a surgeon removes the entire affected lung, the membrane surrounding the heart, part of the muscles between the lungs and abdomen, and the chest lining. A radical resectioning involves the removal of the affected organ as well as the bloody supply and lymph system.) In fact, the surgical team at the M.D. Anderson Cancer Center successfully performed EPPs on 100 mesothelioma patients. About 10 weeks after surgery, 63 patients underwent IMRT procedures.
While IMRT is largely successful in preventing recurrences, patients still risk the cancer developing in other parts of the body. For this reason, combining surgery and radiation with chemotherapy is still the best solution.
Both the Dana-Farber Cancer Institute and the Brigham and Women's Hospital use IMRT following EPP surgery and chemotherapy. This is because researchers had found a high rate of fatal pneumonitis in patients who received only EPP and chemotherapy. Accordingly, oncologists in these hospitals now favor IMRT, especially considering it is more effective and has fewer side effects. As with all treatment methods, IMRT is most successful when used to treat patients with mesothelioma that has not yet spread to surrounding areas. Scientists are also experimenting with helical tomotherapy (HT) and other IMRT systems that give radiologists complete control over how the radiation is administered.
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