Mesothelioma Radiation Treatment

Mesothelioma radiation therapy uses X-rays and other energy beams to shrink tumors and keep them from growing or spreading. It can be used at any stage to prolong the life of a patient or relieve symptoms.

Radiation is also used by surgeons prior to surgery to shrink the tumor, making it easier for surgeons. They may also make use of it to kill cancerous cells that remain after surgery and to prevent any return.

External beam radiation therapy

Radiation therapy involves the use of high-energy beams or X-ray particles to kill cancerous cells. It is difficult to focus radiation mesothelioma cancers because they are usually small, multiple areas of tissue. New methods allow doctors to better pinpoint the cancer and minimize damage to the other parts of the human body. Radiation can be used to eliminate cancerous cells that persist after surgery or chemotherapy. It can be used on its own or together with palliative treatments to lessen the mesothelioma-related symptoms, like pain and difficulty breathing.

External beam radiation therapy is a form of external beam radiotherapy that uses an instrument that directs radiation from outside the body towards the tumor. They first perform a CT scan, MRI or PET scan to determine the exact location of mesothelioma. They then design a plan to deliver radiation to the area while limiting damage to the surrounding tissue. Radiation oncologists can mark your skin in small dots that are freckle-sized to find the affected area. They also mark the treatment field that is the part that requires treatment.

You’ll be lying on a treatment bed and the machine will be placed on the area of your body that is affected by mesothelioma. During your session, you may be asked to move around. But you won’t notice or feel any movements. During the procedure, you might hear clicking or whirring sounds from the machine. The radiation oncologist will monitor you from a room of observation.

EBRT is usually done once a day for 5 days each week for between 2 and 8 weeks. You will receive a number of treatments, based on the purpose of your treatment and the type of radiation utilized. Some EBRT treatments, like intensity modulated radiation therapy (IMRT) makes use of a computer in order to pinpoint the tumor more precisely and reduce radiation exposure to nearby tissues.

Other forms of radiation such as proton beam radiation or SBRT utilize particles instead of X radiation. Proton beam radiation damages DNA of cancer cells, causing them to die earlier than normal cells. This type of treatment could be more precise than EBRT, but it is not yet commonly used to treat mesothelioma.

Intensity-modulated Radiation Therapy (IMRT)

Intensity modulated radiation therapy aligns the radiation beams with the 3-dimensional shape and size of the tumor with 3-D computed-tomography (CT). This allows for higher radiation doses to reach the tumor while keeping the radiation doses to the surrounding organs and tissues. In addition to pleural mesothelioma treatment, IMRT can be used to treat prostate cancer, lung cancer, sarcomas, head and neck tumors.

In studies of patients with complicated tumors, IMRT produces superior dose distributions and lower toxicity when as compared to conventional radiation techniques. Radiation oncologists employ IMRT to determine the treatment plan for their mesothelioma patients and ensure that the radiation is aimed at the right part of the body. Radiation oncologists meet with patients and obtain informed consent before deciding if IMRT would be appropriate for mesothelioma treatments.

Together the radiation oncologist and medical physicist develop an individual IMRT treatment plan for mesothelioma. The radiation therapists then carry out the actual IMRT treatments. During the sessions, the patient is placed on the table. The patient may hear noises or smell odors coming from the machine, but they shouldn’t feel pain. The radiation oncologist and medical physicist remain outside of the room to observe from a secure distance.

During the IMRT session the radiation oncologist will adjust the radiation levels depending on the need to target the cancer. The radiation oncologist could also alter the intensity of the beams to protect vital structures like the heart and large vessels.

At MSKCC the MSKCC team of radiation oncologists have utilized IMRT to treat mesothelioma for more than a decade. Their results demonstrate that IMRT improves lungs function and longevity, and also reduces adverse effects such as radiation esophagitis and radiation pneumonitis. The mesothelioma cases studied had biopsy-proven mesothelioma pleural in the hemithorax, but were not candidates for resection or P/D due to impaired lung function. They were treated using IMRT for the hemithorax with or without pleurectomy. In the group receiving IMRT the overall survival rate was 71 % at one year. It was 53 % after two years.

Brachytherapy

Mesothelioma can be a deadly cancer and radiation therapy eliminates cancerous cells. It also shrinks tumors, making them easier to remove by surgery. It is a targeted treatment that utilizes narrow beams in order to prevent damaging healthy tissue around it.

Radiation is used alone or in conjunction with other cancer treatments such as chemotherapy. Many mesothelioma sufferers are also treated with chemotherapy in addition to lower the chance that cancer will recur after surgery, and make their treatment more efficient.

Brachytherapy involves placing the radioactive source near or within a mesothelioma tumor that allows doctors to deliver a larger dose of radiation to the tumor. This procedure requires hospitalization and doctors may use the 137Caesium source or an Iridium source. mesothelioma treatment options remains in a room that is shielded with the source for 12-24 hours. This treatment may cause some minor adverse effects, including discomfort around the site of the implant and a slight amount of bleeding at the location where the applicator is positioned.

Another option is High-dose Rate (HDR) Brachytherapy, which involves placing several radioactive sources around the tumor and delivering higher doses radiation over a longer duration of time. The procedure typically takes between three and five days and requires an overnight hospital stay. Mesothelioma patients who undergo this kind of brachytherapy might also experience certain short-term adverse effects, such as soreness around the area of insertion as well as a small amount of bleeding from the areas where the applicators were inserted.

Because mesothelioma typically develops as multi-layered masses which makes it difficult to treat with radiation. Newer technology enables radiation specialists to pinpoint the tumor more precisely and also avoid the surrounding tissue.


In some cases, brachytherapy may be used to treat mesothelioma as part of preoperative therapy called Neoadjuvant, or as an adjuvant to surgery to eliminate any mesothelioma tumors that surgeons were unable to remove completely. In addition, some mesothelioma patients are treated with brachytherapy alongside pleurectomy/decortication and conventional radiation therapy as a palliative treatment for their symptoms.

Proton beam radiation

Radiation oncologists use proton beam radiation to target specific areas of a patient’s body where mesothelioma tumors are located. This kind of treatment provides a more precise approach and lowers the chance of exposing healthy tissue to high levels of radiation. Patients with mesothelioma should discuss proton radiation therapy with their doctor to determine if this is the best option for them.

Radiation oncologists create a plan to treat cancerous tissue prior to beginning the proton beam treatment. Dosimetrists make use of computers to calculate the exact amount of radiation required for the region. The doctors also determine which part of the body to deliver radiation, and how far into the body it must travel. Dosimetrists transmit the information to a scientist who utilizes a device called a synchrotron to accelerate protons until they reach the energy level needed to treat.

After the protons reach the treatment room and are directed towards the tumor using a system that is similar to an CT scanner. The patient is placed on a table which moves to match the shape and size of the tumors. The physicist then uses an instrument that rotates the beam’s nozzle around the patient to ensure that the radiation is absorbed by all the areas of the tumor from the most optimal angles.

A gantry device is used to form and direct the proton beam. The gantry is surrounded by an immobilization frame which ensures that the patient remains in a seated position while they are being treated. A computer controls the gantry, which is monitored by a group of radiation technicians who are located in an adjacent room. The radiation oncologist can change the treatment plan if needed during the course of weekly appointments.

Proton beam radiation penetrates the lung tissues less than conventional photon radiation. This means there is less chance of radiation-related complications such as toxicity and the growth of mesothelioma cancer cells which are resistant.

The proton beam is utilized to target mesothelioma-related tumors in the pleural linings of abdomen and lungs. It is important that patients consult mesothelioma experts who have prior experience working with proton radiation.

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