← Back to Search
Radiation Therapy Options For Malignant Pleural Mesothelioma.
Published 2009 · Medicine
Download PDFAnalyze on Scholarcy
The role of radiation therapy (RT) in the curative treatment of malignant pleural mesothelioma remains undefined. No data clearly support treatment of unresected mesothelioma with definitive RT. Early reports showed that RT was associated with unacceptable toxicity, but recent limited data suggest that treatment with intensity-modulated radiation therapy (IMRT) may be tolerable. Adjuvant RT after pleurectomy is also challenging, and similarly, no clear efficacy has been demonstrated. Some approaches, such as IMRT to the circumferential pleural envelope, appear feasible, but the fact that this approach does not address the disease in the fissures is problematic. The best setting in which to deliver RT is after extrapleural pneumonectomy, but the large and irregular target volume and multiple and adjacent sensitive normal structures make this complex. The Memorial Sloan-Kettering Cancer Center matched photon/electron technique is associated with acceptable efficacy and toxicity, but is limited in that it does not achieve complete coverage of the target volume to the prescription dose. The best dosimetry is achieved using IMRT, and this approach is the most promising to date. However, the toxicity profile can be severe, and the relevant predictive factors for complications are not fully understood. For these reasons, physicians should exercise caution, and IMRT after extrapleural pneumonectomy is probably best offered only by experienced teams or on protocol until further data have been gathered. New techniques such as helical tomotherapy and/or IMRT with the addition of electrons may also have a role in future treatment. RT can palliate symptoms provided the disease is confined to a tolerable radiation field.
This paper references
Restricted field IMRT dramatically enhances IMRT planning for mesothelioma.
A. Allen (2007)
Intensity-modulated radiotherapy following extrapleural pneumonectomy for the treatment of malignant mesothelioma: clinical implementation.
K. Forster (2003)
A novel radiation therapy technique for malignant pleural mesothelioma combining electrons with intensity-modulated photons.
M. Chan (2006)
Technique for external beam treatment for mesothelioma.
G. Kutcher (1987)
Intensity-modulated radiation therapy: a novel approach to the management of malignant pleural mesothelioma.
A. Ahamad (2003)
Combined photon and electron three-dimensional conformal versus intensity-modulated radiotherapy with integrated boost for adjuvant treatment of malignant pleural mesothelioma after pleuropneumonectomy.
J. Krayenbuehl (2007)
Outcomes after extrapleural pneumonectomy and intensity-modulated radiation therapy for malignant pleural mesothelioma.
D. Rice (2007)
A phase II trial of surgical resection and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma.
V. Rusch (2001)
Intensity-modulated photon arc therapy for treatment of pleural mesothelioma.
M. Tobler (2002)
Pleurectomy/decortication for palliation in malignant pleural mesothelioma: results of surgery.
O. Soysal (1997)
The potential of proton beam radiation therapy in lung cancer (including mesothelioma)
G. Bjelkengren (2005)
Fatal pneumonitis associated with intensity-modulated radiation therapy for mesothelioma.
A. Allen (2006)
Patterns of failure after trimodality therapy for malignant pleural mesothelioma.
E. Baldini (1997)
Radiation therapy in the management of patients with mesothelioma.
W. Gordon (1982)
Pleurectomy and intraoperative brachytherapy and postoperative radiation in the treatment of malignant pleural mesothelioma.
B. Hilaris (1984)
Tolerance of normal tissue to therapeutic irradiation.
B. Emami (1991)
Inverse planned stereotactic intensity modulated radiotherapy (IMRT) in the palliative treatment of malignant mesothelioma of the pleura: the Heidelberg experience.
M. Muenter (2005)
The Treatment of Malignant Mesothelioma of the Pleura: Review of a 5‐Year Experience, With Special Reference to Radiotherapy
D. Ball (1990)
A novel concept of treatment of diffuse or multiple pleural tumors by boron neutron capture therapy (BNCT).
M. Suzuki (2008)
Induction Chemotherapy, Extrapleural Pneumonectomy, and Postoperative High-Dose Radiotherapy for Locally Advanced Malignant Pleural Mesothelioma: A Phase II Trial
R. Flores (2006)
The diagnosis, therapy and prognosis of diffuse malignant mesothelioma.
R. Achatzy (1989)
Deterioration in lung function following hemithorax irradiation for pleural mesothelioma.
P. Maasilta (1991)
Radiotherapy in the treatment of malignant mesothelioma of the pleura, with special reference to its use in palliation.
S. Davis (1994)
Hyperthermia combined with intra-thoracic chemotherapy and radiotherapy for malignant pleural mesothelioma
Hongqiang Xia (2006)
Malignant pleural mesothelioma: a disease unaffected by current therapeutic maneuvers.
A. Alberts (1988)
Hemithoracic radiation after extrapleural pneumonectomy for malignant pleural mesothelioma.
S. Yajnik (2003)
Hemithoracic radiation therapy after pleurectomy/decortication for malignant pleural mesothelioma.
V. Gupta (2005)
Evaluating target coverage and normal tissue sparing in the adjuvant radiotherapy of malignant pleural mesothelioma: helical tomotherapy compared with step-and-shoot IMRT.
F. Sterzing (2008)
Factors influencing the outcome of radiotherapy in malignant mesothelioma of the pleura--a single-institution experience with 189 patients.
L. de Graaf-Strukowska (1999)
Influence of radiotherapy technique and dose on patterns of failure for mesothelioma patients after extrapleural pneumonectomy.
A. Allen (2007)
Corrigendum to “Inverse planned stereotactic intensity modulated radiotherapy (IMRT) in the palliative treatment of malignant mesothelioma of the pleura: The Heidelberg experience” [Lung Cancer 49S1 (2005) S83–S86]
M. Muenter (2005)
Induction chemotherapy, extrapleural pneumonectomy (EPP) and adjuvant hemi-thoracic radiation in malignant pleural mesothelioma (MPM): Feasibility and results.
F. Rea (2007)
Intensity-modulated radiotherapy for resected mesothelioma: the Duke experience.
E. Miles (2008)
Dose-dependent pulmonary toxicity after postoperative intensity-modulated radiotherapy for malignant pleural mesothelioma.
D. Rice (2007)
Radical pleurectomy/decortication and intraoperative radiotherapy followed by conformal radiation with or without chemotherapy for malignant pleural mesothelioma.
T. T. Lee (2002)
This paper is referenced by
Role of new radiation techniques in the treatment of pleural mesothelioma
M. Amichetti (2013)
Malignant Pleural MesotheliomaPractice Guidelines in Oncology
R. Martins (2012)
Small bowel metastasis from pancreatic cancer in a long-term survival patient with synchronous advanced malignant pleural mesothelioma: A case report and literature review
M. Fasano (2016)
Analysis of patients with malignant and paramalignant pleural effusion
M. Çakmak (2017)
Radiation therapy for malignant pleural mesothelioma
Andrea S. Wolf (2015)
Analysis of patients with pleural effusion who underwent surgery
Gül Evrim (2020)
Surgery for malignant pleural mesothelioma
D. Sugarbaker (2010)
The hedgehog pathway on malignant mesothelioma
C. Lim (2015)
Other Thoracic Malignancies
B. Tieu (2018)
Intensity Modulated Radiation Therapy versus Supportive Care in Malignant Pleural Mesothelioma: A Pilot Study for Treatment Outcomes and Cost-Effective Expectations
M. Ellithy (2018)
Photodynamic therapy for malignant pleural mesothelioma: the future of treatment?
J. Friedberg (2011)
Radiation Therapy for Malignant Pleural Mesothelioma.
K. Rosenzweig (2020)
Pleural resection and pleural infusion chemotherapy for therapy of malignant pleural mesothelioma.
J. Zhang (2014)
Cyberknife radiosurgery for focal paravertebral recurrence after radical pleurectomy/decortication in malignant pleural mesothelioma.
L. Lang-Lazdunski (2012)
Intensity-Modulated Radiation Therapy Improves the Target Coverage Over 3-D Planning While Meeting Lung Tolerance Doses for All Patients With Malignant Pleural Mesothelioma
S. Ulger (2017)
Identifying response to therapy in longitudinal PET imaging studies
M. Phillips (2014)
The Evolution of Multimodality Therapy for Malignant Pleural Mesothelioma
M. Zauderer (2011)
Malignant pleural mesothelioma.
D. Ettinger (2012)
Helical tomotherapy for resected malignant pleural mesothelioma: dosimetric evaluation and toxicity.
P. Giraud (2011)
Evaluation of the photon dose calculation accuracy in radiation therapy of malignant pleural mesothelioma
G. Mahmoudi (2018)
Advances in the diagnosis, treatment and prognosis of malignant pleural mesothelioma.
Weiquan Zhang (2015)
Mesothelioma at era of helical tomotherapy: results of two institutions in combining chemotherapy, surgery and radiotherapy.
A. Sylvestre (2011)
Hyperthermic intraoperative pleural cisplatin chemotherapy extends interval to recurrence and survival among low-risk patients with malignant pleural mesothelioma undergoing surgical macroscopic complete resection.
D. Sugarbaker (2013)
Intérêt de la tomothérapie après pleuro-pneumonectomie extrapleurale dans le mésothéliome pleural malin : premiers résultats cliniques
P. Giraud (2011)
Multimodality therapy for malignant pleural mesothelioma: surgery plus chemoradiotherapy?
A. Wolf (2015)
Pleural mesothelioma: management updates and nursing initiatives to improve patient care
Rebecca H Lehto (2014)
Prise en charge diagnostique et thérapeutique du mésothéliome pleural malin
J. Delourme (2013)