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Prophylactic procedure tract radiotherapy for malignant pleural mesothelioma: A systematic review and meta-analysis

Sarah Bergamin1, Martin Tio2, Mark John Stevens1

  • 1Northern Sydney Cancer Centre - Radiation Oncology Unit, Northern Sydney Cancer Centre, Level 1, Royal North Shore Hospital, Reserve Rd. St Leonards, NSW, 2065, Australia.

Clinical and Translational Radiation Oncology
|October 11, 2018
PubMed
Abstract

Insights

Prophylactic radiotherapy does not prevent procedure tract metastases in malignant pleural mesothelioma (MPM). Close patient monitoring and timely palliative care are recommended for managing symptomatic metastases.

Area of Science:

  • Oncology
  • Radiotherapy
  • Mesothelioma Research

Background:

  • Malignant pleural mesothelioma (MPM) is an aggressive cancer.
  • MPM can spread through procedure tracts, causing symptomatic metastases.
  • Evidence on prophylactic radiotherapy for preventing tract metastases is conflicting.

Purpose of the Study:

  • To systematically review and meta-analyze randomized controlled trials.
  • To estimate the benefit of prophylactic radiotherapy in reducing procedure tract metastases in MPM.
  • To evaluate the role of radiotherapy in managing MPM complications.

Main Methods:

  • Systematic review and meta-analysis of prospective randomized controlled trials.
  • Searched electronic databases up to January 1, 2018.
  • Calculated pooled odds ratios using a random effects model; assessed heterogeneity and publication bias.

Main Results:

  • Included five studies in the meta-analysis.
  • Prophylactic radiotherapy showed no statistically significant reduction in procedure site recurrence (pooled RR 0.69, 95% CI 0.33-1.43).
  • Moderate heterogeneity and moderate to high risk of bias were noted across trials.

Conclusions:

  • Prophylactic radiotherapy has no role in preventing procedure tract metastases in MPM.
  • Effective prophylactic measures are lacking.
  • Close patient monitoring and timely palliative interventions are crucial for managing tract metastases and associated morbidity.
Keywords:
Malignant pleural mesotheliomaProcedure tractProphylacticRadiotherapy

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