Hemithoracic radiation therapy after pleurectomy/decortication for malignant pleural mesothelioma Journal Article
| Authors: | Gupta, V.; Mychalczak, B.; Krug, L.; Flores, R.; Bains, M.; Rusch, V. W.; Rosenzweig, K. E. |
| Article Title: | Hemithoracic radiation therapy after pleurectomy/decortication for malignant pleural mesothelioma |
| Abstract: | Purpose: To evaluate pleurectomy/decortication (P/D) and adjuvant radiotherapy (RT) in the treatment of malignant pleural mesothelioma (MPM). Methods and Materials: In a retrospective review, we included MPM patients treated with P/D and adjuvant RT at Memorial Sloan-Kettering Cancer Center from 1974 to 2003. When indicated, patients received intraoperative brachytherapy to residual tumor. Results: All 123 patients received external beam RT (median dose, 42.5 Gy; range, 7.2-67.8 Gy) to the ipsilateral hemithorax postoperatively. Fifty-four patients underwent brachytherapy (matched peripheral dose, 160 Gy). The median and 2-year overall survival for all patients was 13.5 months (range, 1-199 months) and 23%, respectively. One-year actuarial local control for all patients was 42%. Multivariate analysis for overall survival revealed radiation dose <40 Gy (p = 0.001), nonepithelioid histology (p = 0.002), left-sided disease (p = 0.01), and the use of an implant (p = 0.02) to be unfavorable. Two patients (1.6%) died from Grade 5 toxicity within 1 month of treatment. Conclusions: Pleurectomy/decortication with adjuvant radiotherapy is not an effective treatment option for patients with MPM. Our results imply that residual disease cannot be eradicated with external RT with or without brachytherapy and that a more extensive surgery followed by external RT might be required to improve local control and overall survival. © 2005 Elsevier Inc. |
| Keywords: | adult; cancer survival; controlled study; aged; aged, 80 and over; middle aged; cancer surgery; surgical technique; survival rate; retrospective studies; major clinical study; histopathology; review; adjuvant therapy; cancer radiotherapy; postoperative care; radiation dose; radiotherapy, adjuvant; radiotherapy dosage; radiotherapy; radiation injury; retrospective study; histology; tumors; pleura mesothelioma; mesothelioma; brachytherapy; multivariate analysis; patient treatment; analysis of variance; decortication; pleurectomy; pleura; pleural neoplasms; diseases; beam therapy; medical problems; branchytherapy |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 63 |
| Issue: | 4 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2005-11-15 |
| Start Page: | 1045 |
| End Page: | 1052 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2005.03.041 |
| PUBMED: | 16054774 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 53" - "Export Date: 24 October 2012" - "CODEN: IOBPD" - "Source: Scopus" |
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97Mychalczak -
864Rusch -
8Gupta -
108
Flores -
165
Rosenzweig -
338Bains
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