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Malignant pleural mesothelioma – Pleural cavity irradiation after decortication with helical tomotherapy
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Abstract
Background
Malignant pleural mesothelioma (MPM) is a rare and aggressive disease that poses a treatment challenge in spite of recent technical developments. The aim of this retrospective analysis is to assess the feasibility of administering intensity-modulated radiotherapy (IMRT) to the pleural cavity using helical tomotherapy in patients who had undergone pleurectomy/decortication (P/D) and also the resulting toxicity levels.
Patients and methods
Ten patients who had MPM and had undergone P/D were treated with pleural cavity irradiation that included a median dose of 52.2[[ce:hsp sp="0.25"/]]Gy using helical tomotherapy. The median age of the patients was 53 years (31–74). In addition to clinical and diagnostic findings from regular follow-up examinations, we evaluated the dose distribution for other organs at risk to assess treatment in relation to toxicity, with special regard for the underlying intact lung.
Results
The mean lung dose on the treatment site was 32.8[[ce:hsp sp="0.25"/]]Gy (±6.8). The V20[[ce:hsp sp="0.25"/]]Gy was 71.7% (±17.2). No treatment-related toxicity that exceeded grade III according to common toxicity criteria (CTC) was observed. Median progression-free survival (PFS) was 13 months with a median overall survival (OAS) of 19 months.
Conclusion
The findings of this analysis provide data indicating that sparing the underlying lung in patients with MPM after P/D is not only feasible with helical tomotherapy, but that this treatment also causes reasonably few side effects.
Abstract
Background
Malignant pleural mesothelioma (MPM) is a rare and aggressive disease that poses a treatment challenge in spite of recent technical developments. The aim of this retrospective analysis is to assess the feasibility of administering intensity-modulated radiotherapy (IMRT) to the pleural cavity using helical tomotherapy in patients who had undergone pleurectomy/decortication (P/D) and also the resulting toxicity levels.
Patients and methods
Ten patients who had MPM and had undergone P/D were treated with pleural cavity irradiation that included a median dose of 52.2[[ce:hsp sp="0.25"/]]Gy using helical tomotherapy. The median age of the patients was 53 years (31–74). In addition to clinical and diagnostic findings from regular follow-up examinations, we evaluated the dose distribution for other organs at risk to assess treatment in relation to toxicity, with special regard for the underlying intact lung.
Results
The mean lung dose on the treatment site was 32.8[[ce:hsp sp="0.25"/]]Gy (±6.8). The V20[[ce:hsp sp="0.25"/]]Gy was 71.7% (±17.2). No treatment-related toxicity that exceeded grade III according to common toxicity criteria (CTC) was observed. Median progression-free survival (PFS) was 13 months with a median overall survival (OAS) of 19 months.
Conclusion
The findings of this analysis provide data indicating that sparing the underlying lung in patients with MPM after P/D is not only feasible with helical tomotherapy, but that this treatment also causes reasonably few side effects.
Keywords
Malignant pleural mesothelioma; Pleural cavity irradiation; Pleurectomy/decortication; Tomotherapy
About this articleTitle
Malignant pleural mesothelioma – Pleural cavity irradiation after decortication with helical tomotherapy
Journal
Reports of Practical Oncology and Radiotherapy
Issue
Pages
402-407
Published online
2017-09-01
DOI
10.1016/j.rpor.2017.07.006
Bibliographic record
Rep Pract Oncol Radiother 2017;22(5):402-407.
Keywords
Malignant pleural mesothelioma
Pleural cavity irradiation
Pleurectomy/decortication
Tomotherapy
Authors
Semi B. Harrabi
Stefan A. Koerber
Sebastian Adeberg
Sonja Katayama
Klaus Herfarth
Juergen Debus
Florian Sterzing