Photodynamic Therapy Combined with Radical Pleurectomy

The most successful results regarding malignant mesothelioma stem from treatments of chemotherapy, surgery, radiation therapy, or some sort of combination of the three.  However, an experimental treatment known as photodynamic therapy (PDT) has show promise when used in combination with a surgical procedure called a radical pleurectomy (RP). Photodynamic therapy is a light based cancer treatment that uses light energy to destroy cancerous cells. According to a 2011 study published in the Annals of Thoracic Surgery, when used as a post-surgical treatment, photodynamic therapy may advance the death of any remaining mesothelioma cells that may have been left behind during the surgery. The study, conducted at Pennsylvania University’s Penn Medicine, discovered that the combination of a radical pleurectomy and photodynamic therapy yielded superior results compared to the combination of a modified extrapleural pneumonectomy (MEPP) and PDT.  With the patients’ sexes, ages, diagnoses and treatment history being comparable, the main difference was the two  operations, of which, the radical pleurectomy, along with PDT demonstrated more favorable results. A radical pleurectomy is an invasive surgery involving the complete decortification of the lung and parietal pleura. While an RP may seem extensive, an extrapleural pneumonectomy is even more so. During this procedure a surgeon removes the lining of the chest wall, pericardium, diaphragm, and the entire infected lung. From 2004 to 2008, the study, composing of 28 patients with malignant pleural mesothelioma, underwent macroscopic complete resection, 14 patients by MEPP and the other 14 by RP. Both surgeries were then followed by photodynamic therapy.  Over the course of the study the surgical techniques evolved so much so that 13 of the last 16 patients underwent lung-sparing procedures even though they had an onset of large tumors. Study results for those who were part of the MEPP group showed an overall median survival of 8.4 months. On the other hand, researchers have not yet reached a number for the RP group which is at a median follow-up of 2.1 years. Given the obvious advantage of sparing the lung, RP along with PDT yielded a much more superior overall survival rate compared to MEPP and PDT. With the results, the medical team on the study believe RP plus PDT to be a reasonable option for appropriate patients looking for an aggressive surgical treatment to combat their diagnosis of pleural malignant mesothelioma. Reference: The Annals of Thoracic Surgery. (Febraury 4, 2011) "Photodynampic Therapy and the Evolution of a Lung-Sparing Surgical Treatment for Mesothelioma" Retrieved on June 1, 2011 from The Annals of Thoracic Surgery. Previous: Companies Fined After Forcing Employees to Remove Asbestos Next: Study Finds Similarities in Carbon Nanotube and Asbestos Exposure