A four year study performed at the at Princess Margaret Cancer Centre in
Toronto found that 25 mesothelioma patients who received high dose radiation
just before surgery for resection had 50% improved survival, compared
to patients who underwent surgery before receiving radiation treatments.
The Surgery for Mesothelioma after Radiation Therapy (SMART) approach was
developed by oncologist Dr. John Cho, in collaboration with thoracic surgeon
Dr. Marc de Perrot at Princess Margaret Cancer Centre in Toronto, with
the aim to kill as many cancer cells prior to surgery as possible, to
not only reduce the size of the tumor, but also the risk of the disease
spreading to the lung or abdomen as a result of disruption during surgery.
Doctors administered the radiation over the course of five days in the
week prior to surgery. The high dose method of administering radiation
is made possible through the use of intensity-modulated radiation therapy
(IMRT) an advanced mode of radiotherapy allows the radiation to conform
more precisely to the three-dimensional (3-D) shape of the tumor, reducing
exposure to the heart, spine, and other healthy tissue, and allowing much
higher doses of radiation to be administered that traditional methods.
For the 25 patients in the study, the 3 year survival rate more than doubled
from 32% to 72%. Patients also experienced fewer complications, a quicker
recovery, and a major reduction of the typical treatment cycle from five
months down to one month.
Shortening the diagnostic and treatment period for mesothelioma patients
is imperative, as a majority of patients diagnosed are given a poor prognosis
of only 6 months to live. The SMART approach/protocol makes it possible
to control the disease and improve quality of life for potentially several years.
Since completion of the initial study, Drs. Cho and de Perrot have used
the SMART approach to successfully treat 20 additional mesothelioma patients.
Doctors at the Mayo Clinic in Minnesota will soon begin utilizing the
study is published online in the
Journal of Thoracic Oncology.