What Treatments Are Currently Recommended For Malignant Mesothelioma?
The most favorable treatment outcome recently is reported to be that of a "trimodal" approach, consisting of a radical surgical procedure termed EPP (extra pleural pneumonectomy) in combination with chemotherapy and postoperative radiation therapy.
Extra pleural pneumonectomy involves the complete removal of the affected lung and pleura, pericardium, portions of the phrenic nerve, and the majority of the hemidiaphragm. This extensive surgery is not without significant morbidity and mortality, but it allows for higher radiation doses to be delivered to the chest cavity and it reduces the number of cancerous cells surgically.
Radiation treatment for malignant mesothelioma is more responsive than non-small cell lung cancer, but not as sensitive as is small-cell lung cancer. With malignant mesothelioma, the entire hemithorax must be radiated, creating high risk of damaging the adjacent vital organs such as the heart, esophagus, lung, liver and spinal cord. Chemotherapy for malignant mesothelioma consists of doxorubicin, cyclophosphamide, and cisplatin for four to six cycles postoperatively.
