Radiation Therapy of Malignant Pleural Mesothelioma

Abstract

The role of radiation therapy in malignant pleural mesothelioma is controversial. It has been used as part of multimodal definitive treatment to ameliorate locoregional control after removal of early disease, as prophylaxis to decrease the probability of recurrence and pain at sites of diagnostic or therapeutic instrument insertion and as symptom palliation in patients with advanced disease. Intensity modulated radiotherapy in the adjuvant mode after extrapleural pneumonectomy achieves good local control with acceptable toxicity. Increasing interest can be seen with radical pleural intensity modulated radiotherapy with intact lung. Prophylactic irradiation can be performed for patients who are in good performance status with a longer life expectancy. So far, pain control seems to be the best evidenced application of radiation therapy.

Keywords: Extrapleural pneumonectomy, pleurectomy/decortication, radiotherapy, trimodality therapy.

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