%0 Journal Article
%T Safety and efficacy of helical tomotherapy following lung-sparing surgery in locally advanced malignant pleural mesothelioma.
%A Layer JP
%A Fischer P
%A Dejonckheere CS
%A Sarria GR
%A Mispelbaum R
%A Hattenhauer T
%A Wiegreffe S
%A Glasmacher AR
%A Layer K
%A Nour Y
%A Caglayan L
%A Grau F
%A Müdder T
%A Köksal M
%A Scafa D
%A Giordano FA
%A Lopez-Pastorini A
%A Stoelben E
%A Schmeel LC
%A Leitzen C
%J Strahlenther Onkol
%V 200
%N 7
%D 2024 Jul 22
%M 37993554
%F 4.033
%R 10.1007/s00066-023-02174-7
%X <B>OBJECTIVE: </B>To assess the value of radiation therapy (RT) with helical tomotherapy (HT) in the management of locally advanced malignant pleural mesothelioma (MPM) receiving no or lung-sparing surgery.<BR><B>METHODS: </B>Consecutive MPM cases not undergoing extrapleural pneumonectomy and receiving intensity-modulated (IM) HT were retrospectively evaluated for local control, distant control, progression-free survival (PFS), and overall survival (OS). Impact of age, systemic treatment, RT dose, and recurrence patterns was analyzed by univariate and multivariate analysis. As a secondary endpoint, reported toxicity was assessed.<BR><B>RESULTS: </B>A total of 34 localized MPM cases undergoing IMHT were identified, of which follow-up data were available for 31 patients. Grade 3 side effects were experienced by 26.7% of patients and there were no grade 4 or 5 events observed. Median PFS was 19 months. Median OS was 20 months and the rates for 1‑ and 2‑year OS were 86.2 and 41.4%, respectively. OS was significantly superior for patients receiving adjuvant chemotherapy (p = 0.008).<BR><B>CONCLUSIONS: </B>IMHT of locally advanced MPM after lung-sparing surgery is safe and feasible, resulting in satisfactory local control and survival. Adjuvant chemotherapy significantly improves OS. Randomized clinical trials incorporating modern RT techniques as a component of trimodal treatment are warranted to establish an evidence-based standard of care pattern for locally advanced MPM.