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Radiotherapy for mesothelioma.

Craig W Stevens1, Kenneth M Forster, W Roy Smythe

  • 1Division of Radiation Oncology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612, USA. stevencw@moffitt.usf.edu

Hematology/Oncology Clinics of North America
|December 6, 2005
PubMed
Summary

Malignant pleural mesothelioma treatment combines surgery and radiation for best local control. Further systemic therapies are crucial to combat distant metastases and improve survival for all patients.

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Area of Science:

  • Oncology
  • Thoracic Surgery
  • Radiation Oncology

Background:

  • Malignant pleural mesothelioma affects 3,000-4,000 individuals annually in the US.
  • Current treatments include radiation therapy for palliation and symptom relief.
  • Combined modality treatments are explored for curative intent.

Purpose of the Study:

  • To evaluate the efficacy of combined extrapleural pneumonectomy (EPP) and radiotherapy for malignant pleural mesothelioma.
  • To identify areas for improvement in managing locoregional recurrence and distant metastases.

Main Methods:

  • Review of treatment strategies for malignant pleural mesothelioma.
  • Analysis of outcomes for patients undergoing extrapleural pneumonectomy (EPP) followed by radiotherapy.
  • Assessment of survival rates and patterns of failure.

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Main Results:

  • Extrapleural pneumonectomy (EPP) followed by radiotherapy offers the best local control.
  • Locoregional tumor recurrence is significantly reduced with this combined approach.
  • Aggressive treatment of early-stage patients yields excellent survival rates.

Conclusions:

  • Combined extrapleural pneumonectomy (EPP) and radiotherapy are effective for local control in malignant pleural mesothelioma.
  • The development of improved systemic therapies is essential to address distant metastases.
  • Novel treatment strategies are needed for patients ineligible for EPP.