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Radiotherapy In Malignant Pleural Mesothelioma.

M. McAleer, A. Tsao, Z. Liao
Published 2009 · Medicine

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Malignant pleural mesothelioma (MPM) is a rare malignancy affecting 3,000 people annually in the United States. Although the number of cases is declining in the United States (1), worldwide incidence of MPM is expected to increase over the next decade, particularly in Europe, Asia, and Australia (2). More than 80% of MPM cases have been attributed to asbestos exposure. MPM is typically characterized by manifestation of disease decades after asbestos exposure, accounting for the lag between asbestos regulation and peak MPM incidence (3, 4). Median survival times (MST) for MPM patients range from 9 to 17 months, regardless of disease stage at diagnosis (5, 6). Radiotherapy (RT) has been used in the management of MPM in three ways: as prophylaxis to reduce the incidence of recurrence and pain at sites of diagnostic or therapeutic instrument insertion, as part of multimodal definitive treatment to improve locoregional control after resection of early-stage disease, and for palliation of symptoms for patients with advanced disease. Despite decades of experience with RT use for MPM, given the rarity of this disease, few prospective data are available, and even fewer randomized controlled trials have been conducted to evaluate its efficacy in MPM management. Here, we summarize the experience to date with the use of RT for prophylaxis, definitive therapy, and palliation in MPM.
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