Malignant pleural mesothelioma – Pleural cavity irradiation after decortication with helical tomotherapy

Publication date: September–October 2017
Source:Reports of Practical Oncology & Radiotherapy, Volume 22, Issue 5
Author(s): Semi B. Harrabi, Stefan A. Koerber, Sebastian Adeberg, Sonja Katayama, Klaus Herfarth, Juergen Debus, Florian Sterzing
BackgroundMalignant pleural mesothelioma (MPM) is a rare and aggressive disease that poses a treatment challenge in spite of recent technical developments. The aim of this retrospective analysis is to assess the feasibility of administering intensity-modulated radiotherapy (IMRT) to the pleural cavity using helical tomotherapy in patients who had undergone pleurectomy/decortication (P/D) and also the resulting toxicity levels.Patients and methodsTen patients who had MPM and had undergone P/D were treated with pleural cavity irradiation that included a median dose of 52.2Gy using helical tomotherapy. The median age of the patients was 53 years (31–74). In addition to clinical and diagnostic findings from regular follow-up examinations, we evaluated the dose distribution for other organs at risk to assess treatment in relation to toxicity, with special regard for the underlying intact lung.ResultsThe mean lung dose on the treatment site was 32.8Gy (±6.8). The V20Gy was 71.7% (±17.2). No treatment-related toxicity that exceeded grade III according to common toxicity criteria (CTC) was observed. Median progression-free survival (PFS) was 13 months with a median overall survival (OAS) of 19 months.ConclusionThe findings of this analysis provide data indicating that sparing the underlying lung in patients with MPM after P/D is not only feasible with helical tomotherapy, but that this treatment also causes reasonably few side effects.



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