{Reference Type}: Journal Article
{Title}: Safety and efficacy of helical tomotherapy following lung-sparing surgery in locally advanced malignant pleural mesothelioma.
{Author}: Layer JP;Fischer P;Dejonckheere CS;Sarria GR;Mispelbaum R;Hattenhauer T;Wiegreffe S;Glasmacher AR;Layer K;Nour Y;Caglayan L;Grau F;Müdder T;Köksal M;Scafa D;Giordano FA;Lopez-Pastorini A;Stoelben E;Schmeel LC;Leitzen C;
{Journal}: Strahlenther Onkol
{Volume}: 200
{Issue}: 7
{Year}: 2024 Jul 22
{Factor}: 4.033
{DOI}: 10.1007/s00066-023-02174-7
{Abstract}: OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.