A pilot trial of high-dose-rate intraoperative radiation therapy for malignant pleural mesothelioma Journal Article
| Authors: | Rosenzweig, K. E.; Fox, J. L.; Zelefsky, M. J.; Raben, A.; Harrison, L. B.; Rusch, V. W. |
| Article Title: | A pilot trial of high-dose-rate intraoperative radiation therapy for malignant pleural mesothelioma |
| Abstract: | PURPOSE: To report results of a phase II trial of high-dose-rate intra-operative radiation therapy (HDR-IORT) for malignant pleural mesothelioma (MPM). METHODS AND MATERIALS: Seven patients had extrapleural pneumonectomy with IORT (EPP/IORT) and 6 patients had pleurectomy/decortication with IORT (PD/IORT) between 1994 and 1996. IORT was delivered with 192Ir using a customized applicator with a remote afterloader. A median of 3 sites were treated to a median area of 143 cm 2. A dose of 1500 cGy was prescribed at each site, with 1000 cGy delivered to the mediastinum. Postoperative external beam radiation therapy (EBRT) was given 3-5 weeks later. Median follow-up was 8 months (range, 1-84 months). RESULTS: Five patients developed local failure. Two-year local control and survival rates were 35% and 23%, respectively. Mortality was 2/13 (15%), 1 from each surgical group. Serious complications requiring further intervention occurred in 3/6 (50%) of the EPP/IORT group and 1/5 (20%) of the PD/IORT group. CONCLUSIONS: HDR-IORT after EPP for MPM is prohibitively toxic and has been abandoned, while its use with PD remains in question. © 2005 American Brachytherapy Society. All rights reserved. |
| Keywords: | cancer survival; clinical article; controlled study; survival rate; treatment failure; mortality; patient selection; postoperative care; follow up; intraoperative care; lung resection; radiotherapy dosage; radiotherapy; radiation response; prescription; correlation analysis; feasibility study; pilot study; pilot projects; radiosurgery; pleura mesothelioma; mesothelioma; brachytherapy; extrapyramidal syndrome; intermethod comparison; radiation therapy; radiation beam; cancer control; mediastinum; extrapleural pneumonectomy; decortication; pleurectomy; pleural neoplasms; iridium 192; peroperative care; gamma radiation; ham applicator; hdr-iort |
| Journal Title: | Brachytherapy |
| Volume: | 4 |
| Issue: | 1 |
| ISSN: | 1538-4721 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2005-01-01 |
| Start Page: | 30 |
| End Page: | 33 |
| Language: | English |
| DOI: | 10.1016/j.brachy.2004.11.003 |
| PUBMED: | 15737904 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 8" - "Export Date: 24 October 2012" - "CODEN: BRACC" - "Source: Scopus" |
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