| Abstract: |
Radiation therapy (RT) is an important treatment option for malignant pleural mesothelioma (MPM). It can be employed as part of a definitive multimodality treatment approach in conjunction with chemotherapy and surgery in an attempt to control the disease locally. The complex anatomy of the pleura and its proximity to vital organs at risk, such as the lungs, heart, esophagus, and brachial plexus, pose distinct challenges. Novel techniques such as intensity-modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT), or proton therapy are able to precisely deliver effective RT doses while minimizing toxicities. Prospective studies have demonstrated the technical feasibility and safety of IMRT pre- or post-surgery with encouraging clinical outcomes. Ongoing studies are expanding the expertise of these complex RT techniques to more mesothelioma centers as the basis for performing high-quality multicenter prospective clinical trials that may determine the true efficacy of the addition of RT to surgical and systemic therapies. RT also plays an important role in the palliation of MPM-related pain, obstructive symptoms, and vascular invasion. © Springer Nature Switzerland AG 2019, corrected publication 2019. |
