Current surgical and/or chemotherapy treatment of patients with malignant pleural mesothelioma are unsatisfactory and have not been shown to significantly prolong life and may lead to worsened pulmonary function. In this study will investigate whether complete removal of the affected lung can be avoided by using chemical and radioactive substances injected repeatedly into the pleural space, surrounding the lung but penetrating and destroying only the cancerous lining, not the underlying uninvolved lung tissue.
The proposed treatment takes approximately 13 weeks. Patients will undergo exploratory surgery through a small incision in their chest wall using a special surgical camera called a thoracoscope in order to place two tubes in the space surrounding the lung into which drugs can be delivered. After these tubes are placed, the doctor will administer over the course of the next 9 weeks chemotherapy (cisplatin and doxorubicin) followed by a single treatment with radiotherapy (P-32) during week 12. Both chemotherapy and P32 radiotherapy are administered directly into the pleural cavity. None of these maneuvers precludes later treatment with conventional surgery, radiotherapy, or chemotherapy.
The potential significance of the research is that such treatment may make it possible fully treat selected patients with mesothelioma without surgically removing the entire affected lung, leading to less disfigurement, better lung function, improvement in their quality of life, and longer patient survival.