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Implantation and Monitoring by PET/CT of an Orthotopic Model of Human Pleural Mesothelioma in Athymic Mice
Published on: December 21, 2019
Needle-track metastases and prophylactic radiotherapy for mesothelioma
Sophie D West1, Tina Foord, Robert J O Davies
1Oxford Pleural Clinic, Oxford Centre for Respiratory Medicine, Churchill Hospital, Headington, Oxford OX3 7LJ, UK. sophie@west66.freeserve.co.uk
Background:
Mesothelioma invades the tracts made by chest instrumentation. Prophylactic radiotherapy is effective at preventing malignant seeding at these sites.
Methods:
We assessed the use and effectiveness of radiotherapy at our centre in 39 of the 40 patients identified with mesothelioma between January 2000 and September 2003.
Results:
Thirty-seven (95%) patients received radiotherapy to their chest instrumentation site between 6 and 42 days (median 26 days) following the diagnosis of mesothelioma. The radiotherapy field size varied, from 4 cm square to 14 x 10.5 cm. The radiotherapy was given as 21 Gy in 3 fractions over 1 week. In 3 patients (8%), there was already tumour invasion of the skin at the time of radiotherapy. In 2 other patients (5%), there was tumour recurrence following radiotherapy; in both this was at the edge of the previous radiotherapy fields. Further treatment was administered to an adjacent field in both. One patient with an indwelling pleural catheter developed tumour growth at the catheter insertion site. This was treated successfully with radiotherapy, with no catheter damage.
Conclusions:
Prompt radiotherapy referral and radiotherapy field selection is important to maximise the effect of radiotherapy given to prevent chest wall tumour growth. There was no tumour growth in areas that were treated with radiotherapy. Further chest interventions outside the radiotherapy field should be followed with further radiotherapy.
Insights
Prophylactic radiotherapy effectively prevents mesothelioma seeding at chest instrumentation sites. Prompt referral and precise field selection maximize radiotherapy
Area of Science:
- Oncology
- Radiation Oncology
- Thoracic Surgery
Background:
- Mesothelioma can invade chest instrumentation tracts.
- Prophylactic radiotherapy is a proven method to prevent malignant seeding at these sites.
Purpose of the Study:
- To assess the use and effectiveness of radiotherapy in preventing mesothelioma seeding at chest instrumentation sites.
Main Methods:
- Retrospective review of 39 mesothelioma patients treated between January 2000 and September 2003.
- Analysis of radiotherapy application, field size, dosage (21 Gy in 3 fractions), and patient outcomes.
Main Results:
- 95% of patients received radiotherapy to chest instrumentation sites within a median of 26 days post-diagnosis.
- No tumor growth occurred in treated areas; 8% had pre-radiotherapy skin invasion.
- Tumor recurrence at field edges occurred in 5% of patients, managed with adjacent field radiotherapy.
Conclusions:
- Prompt radiotherapy referral and accurate field selection are crucial for preventing chest wall tumor growth.
- Radiotherapy is effective in preventing tumor seeding at instrumentation sites.
- Further radiotherapy is recommended for chest interventions outside the initial treatment field.
