Radiation Treatment in Mesothelioma
Mesothelioma patients can receive radiation treatment as part of their pleural mesothelioma treatment program. It may help decrease the chances that cancer will return after surgery.
Radiation therapy uses ionizing radiation that damages DNA within cells and kills them. It is available prior to or after surgery.
Doctors often combine it with chemotherapy to increase surgical success. It can also ease symptoms by shrinking tumors that cause discomfort, such as breathlessness.
External beam radiation therapy (EBRT)
The treatment relies on x-rays or particles that are produced by an outside machine to eliminate cancerous cells. It can be used before or after surgery, chemotherapy, or both to kill cancerous cells within the affected area. It can also be utilized as a treatment for palliative care to ease symptoms such as breathlessness. Mesotheliomas do not grow as a single distinct tumors, therefore it can be difficult to target radiation at them while sparing healthy tissue. Newer techniques are helping to overcome this issue.
Experts in radiation use computers to produce detailed images of the tumor as well as nearby healthy tissues. These images assist them in deciding how much radiation to use and where it should be directed. This information is used by a large machine to place the radiation beam on the tumor precisely. The majority of EBRT procedures require treatment every day for weeks, although certain patients require less treatments. Each session is between 15 and 30 minutes, however most of the time is spent getting the patient in the correct position for the treatment.
The kind of EBRT that is used to treat mesothelioma will rely on the location of tumors and the health of the patient. It could be a standard EBRT, known as three-dimensional conformal radiotherapy (3D-CRT) or a more advanced method like intensity modulated radiation therapy (IMRT). In some cases it could be paired with a more specific method such as stereotactic body radiation therapy to treat larger tumors, or with other treatment methods like intraoperative radiation therapy to treat smaller tumors that can't be removed surgically.
Another radiation treatment option is proton beam radiation therapy, which involves aiming particle beams (like protons or Helium Ions) at the tumor from different angles. This allows for targeted treatment that is more precise and reduces the chance of damage to nearby healthy tissues and organs. In Australia, proton radiation treatment for mesothelioma has not become widespread.
treatment for mesothelioma in the lungs of radiation, intraoperative radiation therapy (IORT) is used in conjunction with surgery to kill any mesothelioma which could not be removed surgically. This is a quick procedure that takes just few minutes to complete.
Intensity-modulated Radiation Therapy (IMRT)
IMRT is a treatment that allows doctors to treat tumors without causing harm to healthy tissue. The treatment utilizes a medical linear acceleration (LINAC) device which emits X-rays or photons to target the tumor. The machine rotates around the patient, permitting the beam to be directed at various angles to ensure that every area is being treated. This allows the doctor to deliver more doses to the tumor, while protecting the surrounding healthy tissues from being damaged.
IMRT is a method of Image-Guided Radiation Therapy, which helps the physician target the exact site of the cancer. IGRT uses computerized imaging, like CT scans or X-rays as well as MRI scans if they are available to assist the radiation oncologist to locate the mesothelioma and surrounding areas with precision. Once the area of interest has been located, the IMRT can be used to create an treatment strategy that targets the mesothelioma precisely.
The IMRT system allows the doctor to tailor treatment to the specific anatomy of each patient, thereby reducing the risk of side effects. Radiation oncologists typically give patients five daily IMRT treatments every week, for five to eight consecutive weeks. Each session is between 15 and 30 minutes. The daily dose of radiation is designed to protect the body's normal tissue. It is also important to keep in mind that a weekend rest break is often necessary so that the body's healthy tissues are able to recover.
The IMRT technique has shown good results for patients suffering from mesothelioma of the head and neck. It is particularly effective for tumors located near radiosensitive structures, such as the parotid glands, as a recent study showed that IMRT allows a significant dose to be delivered to the tumor while avoiding the parotid gland. The spared parotid glands recovered to 63% of their pre-treatment level as compared to only 3 percent in patients who received conventional radiation. This is an encouraging result, but more research is required. Large-scale trials using IMRT will be required to confirm these preliminary findings.
Brachytherapy
Radiation can shrink a tumor and reduce symptoms if doctors are unable to eliminate the mesothelioma. Palliative care is what this is known as. Doctors combine it with other treatments such as chemotherapy and neoadjuvant therapy to extend the lifespan of patients.
Radiation therapy involves the use of x-rays to kill cancerous cells in an outside machine. New methods, such as IMRT, allow doctors to better target the area surrounding the tumor, and reduce radiation damage.
Some forms of radiation can also be utilized inside the body to kill cancer cells. In brachytherapy doctors place a radioactive source that is sealed material in or near mesothelioma. This can be done with an applicator or catheter. Doctors can then administer doses of radiation from a device outside the body to target the source of. This is called external radiation therapy (EBRT).
In brachytherapy, doctors are able to provide patients with either pulsed-dose or high-dose rates of radiation. In the first patients, they stay in the hospital and may receive 10-minute sessions daily for a period of two weeks. High-dose brachytherapy requires a bigger machine with longer exposure times, is not as common.
Protons are employed in a different kind of brachytherapy that is not the x-rays. Protons are physical particles and are therefore less likely be absorbed by tissue. This could result in less damage in the surrounding area. However, this form of radiation is more costly and isn't as widely available as x-rays.
Mesothelioma patients may need to undergo radiation therapy for several weeks or more. This can be extremely difficult to bear. Patients should discuss with their doctors any side effects that they may suffer from during treatment. Patients should also ask their doctors for tips on how to reduce side effects.
Apart from radiation, mesothelioma patients may benefit from immunotherapy and gene therapy as part of their multimodal treatment plan. Immunotherapy can boost the immune system and mesothelioma sufferers who have had chemotherapy can benefit from using immunotherapies to boost their chemotherapy regimen.
Mesothelioma researchers are also looking into other methods to improve mesothelioma outcomes with radiation therapy. One option is to combine brachytherapy and immunotherapy, which involves injecting cells that are infused with the drug Yervoy into the chest cavity. Clinical trials have shown that this treatment is effective. Gene therapy is a different treatment that involves replacing genes in mesothelioma cancer cells or repairing them to suppress their growth and make them more vulnerable to chemotherapy.
Radiation therapy after surgery
The treatment of radiation is not an effective treatment for mesothelioma however, it can significantly improve a patient's prognosis. When it is used as part of a multimodal treatment plan, radiation can shrink mesothelioma tumors, and reduce pain and discomfort caused by the cancer. It can also reduce the chance of mesothelioma cancer cells spreading during surgery or following the removal of a pulmonary tumor (known as "seeding").
Each session lasts for about 30 minutes. The treatment can be uncomfortable since the radiation oncologist will need to hold and position the patient in a certain position.
Before the session begins the participants are advised to dress comfortably. They should also stay clear of wearing any metal, which can interfere with the accuracy of the equipment. Patients should also eat six small meals throughout the day to prevent nausea caused by the treatments.
Based on the condition of a patient depending on the patient's condition, they could receive either a conventional type of radiation or brachytherapy. During conventional radiation treatment doctors use an accelerator machine to deliver radiation. This is the most popular mesothelioma treatment. It is typically used to treat the pleural msothelioma which develops on the lung's lining.
Brachytherapy is an improved treatment that utilizes an implanted radiation source inside the body. The implant may be permanent or temporarily placed. When inserting the implant, the doctor must ensure that only cancerous tissue is targeted and not the organs surrounding it.
Researchers are investigating the possibility of combining radiation therapy with surgical procedures in mesothelioma trials for patients with resectable mesothelioma. One example is the SMART trial. This treatment method is experimental and involves giving patients extrapleural pneumonectomy prior to the procedure of hemithoracic radiotherapy. This combination of treatments enables doctors to provide patients with higher doses and reduce the chance of post-surgical mesothelioma seeding.
Patients with mesothelioma can suffer a complete or partial remission. This means that the size of the tumor has decreased or even disappeared completely. Some patients have experienced remission over a period of time and have survived beyond their initial prognosis.