January 24, 2013 — Results of clinical research that treated mesothelioma with radiation before surgery show the three-year survival rate more than doubled for study participants afflicted with this deadly disease, compared to treating with surgery first.
The Journal of Thoracic Oncology published the findings, which chart a route to treat patients effectively and improve their quality of life and potential survival, said principal investigator and lead author John Cho, M.D., radiation oncologist at Princess Margaret Cancer Centre, University Health Network (UHN).
“The patients in our study experienced shorter treatment, fewer complications and speedier recovery,” Dr. Cho said. “The three-year survival rate more than doubled to 72 percent from 32 percent.”
Mesothelioma is an aggressive malignancy that starts in the lining of the lung and progressively restricts and invades the whole organ. The study assessed Surgery for Mesothelioma After Radiation Therapy (SMART), which was completed over four years with 25 patients who underwent radiation therapy at Princess Margaret Cancer Centre and surgery at Toronto General Hospital, both part of UHN.
Participants were treated with an accelerated, five-day course of intensity-modulated radiation therapy (IMRT), a specialized technique that conforms the radiation dose around the tumors in 3-D while sparing the heart, spine and other healthy tissues. Patients’ affected lungs were removed the following week.
The SMART approach reduced the treatment cycle for patients to one month from five months and reduced the risk of recurrence because radiation prevented the cancer from seeding elsewhere in the chest or abdomen during surgery.
Exposure to asbestos is the main cause of mesothelioma in the 500 new cases reported in Canada each year.
For more information: www.theprincessmargaret.ca, www.uhn.ca
November 04, 2025 
