Mesothelioma: The Role For Radiation Therapy

Our plain-English summary of Mesothelioma: The Role For Radiation Therapy, by L.W. Brady (1981).

The study

• Author: L.W. Brady
• Published: Seminars In Oncology 8(3):329-334, September (1981)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 000722. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1981 article was mainly a review, though it also briefly reported results from small patient series at Hahnemann Medical College in Philadelphia. The author reviewed published experience with radiation therapy for pleural and peritoneal mesothelioma, alongside surgery and chemotherapy. The author noted that there were no controlled or systematic clinical studies of treatment. For pleural mesothelioma at Hahnemann, the entire half of the chest was treated with radiation doses described as ranging up to 6500 rads in 6.5 weeks, with shielding of the heart and spinal cord. In a series of 10 patients, median survival was 12 months. In a separate series of six patients given radioactive colloidal compounds into the chest cavity, all six were alive 12 months or longer. For peritoneal mesothelioma, the author described the radiotherapy experience as anecdotal at best and its value as unclear. The author called malignant mesothelioma, at that time, a uniformly fatal disease. The author concluded that only aggressive combined treatment with surgery, radiation therapy and chemotherapy would improve long-term survival in more advanced mesothelioma.

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: Narrative review of the literature on radiation therapy for mesothelioma, with brief reports of the author's institution's own treatment series
• Who was studied: Patients with pleural and peritoneal mesothelioma in published reports. Also two small series treated at Hahnemann Medical College, Philadelphia: 10 patients given chest radiation and six patients given radioactive colloidal compounds. Dates are not given.
• Exposure: No exposure was studied. The subject was treatment: external radiation therapy, instillation of radioactive colloidal gold and radioactive chromic phosphate, and their combination with surgery and chemotherapy. Asbestos is mentioned only as background, as associated with the diffuse malignant form; no fiber types are named.
• Main results:
  • At Hahnemann, the entire hemithorax was treated with radiation doses described as ranging up to 6500 rads in 6.5 weeks (the lower figure is garbled in the scan), with shielding of the heart and spinal cord.
  • In a Hahnemann series of 10 patients given this chest radiation, the median duration of survival was 12 months.
  • In a Hahnemann series of six patients given radioactive colloidal compounds, all six were alive 12 months or longer after instillation.
  • For peritoneal mesothelioma, the author described the experience with total-abdomen radiation as anecdotal at best and its value as unclear.
• The authors' conclusion: The author concluded that malignant mesothelioma was at that time uniformly fatal, and that only aggressive use of combined-modality treatment (surgery, radiation therapy and chemotherapy) would improve long-term survival in more advanced mesothelioma.
• Limitations the authors state:
  • The author stated that there were no controlled or systematic clinical studies of therapy, which made the anecdotal reports difficult to evaluate.
  • The author stated that valid conclusions about the effectiveness of higher radiation doses for pleural mesothelioma could not yet be made.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Peritoneal Mesothelioma, Chemotherapy, Pleural Mesothelioma, Median Overall Survival.

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