Pat Guth contributes news and insightful content for the Mesothelioma Cancer Alliance. Bio »
May 04, 2012
Melbourne, Australia - A study authored by Dr. Malcolm Feigen, M.D. of the Austin Health Radiation Oncology Center in Melbourne, Australia appears to demonstrate that the use of high-dose hemithoracic radiation may serve to increase the life expectancy of those suffering from the very aggressive cancer known as mesothelioma. The findings from this small patient series, says Feigen, dispute the notion many experts have that mesothelioma is radiation insensitive. He presented his data last week at the European Lung Cancer Conference.
"I stood before [the ELCC] 2 years ago to present the first 14 patients we had analyzed, and asked whether there was a role for high-dose hemithoracic radiotherapy in unpneumonectomized mesothelioma patients," said Feigen during his address. "I think now that the answer to that question is 'absolutely.'"
"Our experience provided clear evidence that radiation is arguably the most effective single agent for mesothelioma and new technology, including intensity-modulated radiotherapy (IMRT), allow high doses to be delivered safely," he continued.
Some in attendance questioned the validity of Feigen's findings, noting that the study was based on an unselected patient series and not a controlled clinical trial. For example, Dr. Paul Baas of the Netherlands questioned the interaction of high-dose radiation with some of the other drugs used to treat malignant mesothelioma.
"I think IMRT in mesothelioma is possible but you have to be aware of the risks," explained Baas. "Toxicity should be part of any trial to study this. We have some evidence that a combination of 3-D conformal and IMRT might limit the risk.
"I think it is time for a joint study, because if everybody goes on doing what he or she thinks is best at his or her hospital, then we will not be able to compare the results," Baas added.
Still, Feigen defended his findings, noting that median overall survival for all 45 patients was 7.9 months for patients treated by 3-D conformal radiation therapy and 12.4 months for the IMRT group. Estimated 1-year survival was 44% with 3-D conformal radiation and 54% with IMRT.
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