IMPRINT Technique Successful in Treating Locally Advanced Mesothelioma
A new radiation procedure called intensity-modulated pleural radiation therapy (IMPRINT) can now be safely and effectively.
Posted in: New Treatments
October 03, 2016
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A new radiation procedure called intensity-modulated pleural radiation therapy (IMPRINT) can now be safely and effectively combined with lung-sparring surgery to help mesothelioma patients improve their quality of life and survival time. The procedure is now used by a small number of mesothelioma specialty centers after a whole decade of refinement. The phase II study of IMPRINT revealed the procedure has an acceptably low incidence rate of radiation pneumonitis, which is a potential adverse side effect.
45 patients were enrolled at either Memorial Sloan-Kettering Cancer Center in New York or MD Anderson Cancer Center in Houston, TX. Patients received up to 4 cycles of chemotherapy with pemetrexed and a platinum agent. Of these 45 patients enrolled:
- 27 patients started hemithoracic IMPRINT
- 9 experienced disease progression before IMPRINT
- 5 refused surgery or IMPRINT
- 2 underwent an extrapleural pneumonectomy at the time of surgery
- 2 had chemotherapy complications
- 26 patients received pemetrexed plus cisplatin
- 18 had pemetrexed plus carboplatin
- 4 received a combination
- 28.9% achieved a partial response
- 33.3% experienced progressive disease
- 1 patient died during chemotherapy, and all others had stable disease
- 8 patients underwent pleurectomy-decortication or an extended version
- 13 underwent a partial pleurectomy-decortication
At a median follow-up of 21.6 months, 6 of the 27 patients who started IMPRINT faced grade II radiation pneumonitis, while 2 of them experienced grade III radiation pneumonitis, but all recovered after the initiation of corticosteroids. There were no grade IV or V radiation-related toxicities observed. Median progression-free survival was 12.4 months and median overall survival was 23.7 months. The 2-year overall survival rate was 59% in patients with resectable and 25% among patients with unresectable tumors.
Thus, combining the hemithoracic IMPRINT procedure with chemotherapy and pleurectomy-decortication creates a new lung-sparing treatment modality for patients with locally-advanced, malignant pleural mesothelioma. Physicians hope that this study will encourage more cancer centers and clinics to embrace the IMPRINT technique.
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