Radiation Guidelines Issued for Lung Cancer Patients May Help in the Treatment of Mesothelioma Patients

Radiation is one of the primary treatment options for mesothelioma and lung cancer patients. It is used to control the growth or spread of the cancer and, for palliative care, to reduce pain or other symptoms caused by the cancer. Now, according to the American Society for Radiation Oncology (ASTRO), when used according to the organization’s new guidelines, Stereotactic Body Radiation Therapy (SBRT) can be effective in treating lung cancer patients who are not eligible for surgery.

According to the June 12 press release from ASTRO announcing the guidelines, SBRT can be useful for the care of early-stage lung cancer patients who are not “fit enough” for surgery,  for the use of non-operable large lung tumors as well as for patients who have undergone pneumonectomy surgery, removal of a lung, and have a new primary tumor in the other lung.

The guidelines offer directions for tailoring treatment for high-risk scenarios, and for “salvage therapy” for medically inoperable patients with recurrent early-stage disease.

SBRT technology is used in the treatment of thoracic cancers including non-small cell lung cancer (NSCLC) and mesothelioma. SBRT uses three-dimensional coordinates which brings a high degree of precision, offering very high doses of extremely precise radiation. The accuracy maximizes the cell-killing effect on the targeted cells while sparing adjacent, healthy tissue. SBRT also allows treatment in a shorter amount of time.

Pleural mesothelioma, a pulmonary cancer directly related to inhaling asbestos fibers, often has a complex growth pattern making surgery difficult. The mesothelioma tumors are often located close to other organs which limits the ability of the oncologists to order radiation treatment in high enough doses to successfully attack the cancer. However, SBRT can be effective for mesothelioma due to the pinpoint-targeting capabilities and the shorter amount of time than traditional treatments. Often just one to five treatments are needed.

“NSCLC is a complex disease, with a great deal of heterogeneity among patients. This guideline reinforces SBRT as the standard of care for medically inoperable patients, but it also examines the safety and efficacy of SBRT in less traditional clinical scenarios, such as patients with larger tumors or recurrent patients with early-stage disease,” said Megan E. Daly, MD, co-chair of the task force and a radiation oncologist at the University of California, Davis in Sacramento, California.

A previous study into the effectiveness of SBRT found that due to the precision required in the delivery of SBRT therapy, ensuring accurate delivery of the intended radiation “requires rigorous quality control and quality assurance measures for treatment planning and treatment delivery.”

Mesothelioma patients are encouraged to discuss all of their treatment options with their oncologist and medical team.

Lung cancer is the leading cause of cancer death in men and women with an estimated 222,500 new diagnoses and 155,870 deaths in 2017, according to the National Cancer Institute. Nearly 3,000 Americans are diagnosed with mesothelioma each year.

Read the full guidelines for SBRT treatment in the journal Lung Cancer.