Clinical outcomes of stereotactic body radiation therapy for malignant pleural mesothelioma Journal Article
| Authors: | Shin, J. Y.; Offin, M.; Simone, C. B. 2nd; Zhang, Z.; Shepherd, A. F.; Wu, A. J.; Shaverdian, N.; Gelblum, D. Y.; Gomez, D. R.; Sauter, J. L.; Ginsberg, M. S.; Adusumilli, P. S.; Rusch, V. W.; Zauderer, M. G.; Rimner, A. |
| Article Title: | Clinical outcomes of stereotactic body radiation therapy for malignant pleural mesothelioma |
| Abstract: | Background: The objective of this study is to determine the outcomes and toxicities of patients with malignant pleural mesothelioma (MPM) treated with stereotactic body radiotherapy (SBRT). Materials and methods: Data were extracted from an institutional tumor registry for patients diagnosed with mesothelioma and treated with SBRT. Kaplan-Meier and Cox regression analyses were employed to determine local control (LC) and overall survival (OS). Results: Forty-four patients with 59 total treated tumors from December 2006 to April 2022 were identified. Fifty-one (86.4 %) cases had oligoprogressive disease (five sites or less). The median prescription dose delivered was 3000 cGy in 5 fractions (range: 2700–6000 cGy in 3–8 fractions). Fifty-one (86.4 %) tumors were in the pleura, 4 (6.8 %) spine, 2 (3.4 %) bone, 1 (1.7 %) brain, and 1 (1.7 %) pancreas. The median follow-up from SBRT completion for those alive at last follow-up was 28 months (range: 14–52 months). The most common toxicities were fatigue (50.8 %), nausea (22.0 %), pain flare (15.3 %), esophagitis (6.8 %), dermatitis (6.8 %), and pneumonitis (5.1 %). There were no grade ≥ 3 acute or late toxicities. There were 2 (3.4 %) local failures, one of the pleura and another of the spine. One-year LC was 92.9 % (95 % CI: 74.6–98.2 %) for all lesions and 96.3 % (95 % CI: 76.5–99.5 %) for pleural tumors. One-year LC was 90.9 % (95 % CI: 68.1–97.6 %) for epithelioid tumors and 92.1 % (95 % CI: 72.1–98.0 %) for oligoprogressive tumors. One-year OS from time of SBRT completion was 36.4 % (95 % CI: 22.6–50.3 %). On multivariable analysis, KPS was the lone significant predictor for OS (p = 0.029). Conclusions: Our single-institutional experience on patients with MPM suggests that SBRT is safe with a low toxicity profile and potentially achieve good local control. © 2023 Elsevier B.V. |
| Keywords: | adult; controlled study; aged; major clinical study; overall survival; fatigue; bevacizumab; cisplatin; systemic therapy; gemcitabine; positron emission tomography; follow up; pancreas; ipilimumab; computer assisted tomography; esophagitis; nausea; pneumonectomy; distant metastasis; pneumonia; prescription; immunotherapy; brain; spine; bone; malignant mesothelioma; pleura mesothelioma; recurrent disease; pleura tumor; dermatitis; local control; toxicity; acute toxicity; stereotactic body radiation therapy; decortication; pleurectomy; pleura; sbrt; gross tumor volume; clinical outcome; re-irradiation; planning target volume; nivolumab; human; male; female; article; avelumab; oligoprogression |
| Journal Title: | Radiotherapy and Oncology |
| Volume: | 191 |
| ISSN: | 0167-8140 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2024-02-01 |
| Start Page: | 110057 |
| Language: | English |
| DOI: | 10.1016/j.radonc.2023.110057 |
| PUBMED: | 38104783 |
| PROVIDER: | scopus |
| PMCID: | PMC10923065 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Jacob Shin -- Source: Scopus |
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