Adding a technique called Cold Plasma Coagulation to the mix when using surgery and intra-operative chemotherapy seems to help protect mesothelioma patients against certain complications, according to a new study.
Mesothelioma, a
malignancy that affects the linings around the lungs and internal
organs, is caused by asbestos exposure and is notoriously difficult to
treat. Depending on the stage of their cancer and their health status,
most patients receive a combination of treatments which may include
chemotherapy, radiation, radical surgery
(Extrapleural pneumonectomy or EPP), or pleurectomy and decortication
(P/D), a less radical surgical approach. Even with these various
combinations, many patients succumb to the disease within 18 months of
diagnosis.
In an effort to
improve mesothelioma survival rates, surgeons in recent years have begun
combining pleurectomy and decortication with heated chemotherapy
(hyperthermic intrathoracic chemoperfusion or HITHOC) that is washed
through the effected body cavity during surgery. While results of this combination therapy have been promising, there is the potential for damaging the pericardium (lining around the heart) or the diaphragm, leading to heart damage or the accidental spread of cancer cells into the abdomen.
Now, researchers in Germany believe they have found a way to protect the pericardium
and the diaphragm during P/D, while still allowing mesothelioma
patients to benefit from the surgery and the HITHOC treatment. In the
study, Cold Plasma Coagulation (CPC) was used to destroy tumor cells on the pleura, diaphragm and pericardium before HITHOC was administered.
Patients in the
study all had Stage III pleural mesothelioma. None of them suffered any
cardiotoxic effects as the result of their treatment and none had had a
recurrence of their cancer one year after surgery. The researchers
concluded that Cold Plasma Coagulation was a safe and potentially beneficial addition to a multimodal treatment approach for mesothelioma patients.
In their abstract,
the authors noted that the number of cases of mesothelioma continues to
rise and is not expected reach its peak until 2015. They caution, “We
consider our trial as a pilot study. To evaluate potential survival
benefits using this [Cold Plasma] technique, larger trials are mandatory.”
The study titled “Cold-Plasma
Coagulation in the Treatment of Malignant Pleural Mesothelioma: Results
of a Combined Approach”, was published in the online journal
Interactive Cardiovascular and Thoracic Surgery.
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