Malignant Pleural Mesothelioma: Preliminary Toxicity Results of Adjuvant Radiotherapy Hypofractionation in a Prospective Trial (MESO-RT)

Malignant Pleural Mesothelioma (MPM) is a rare malignancy with an overall poor prognosis. The standard therapeutic strategy in early-stage disease is trimodality therapy. In this publication, we report the preliminary toxicity results of the first 20 patients treated with accelerated hypofractionate...

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Bibliographic Details
Published in:Cancers 2023-02, Vol.15 (4), p.1057
Main Authors: Parisi, Elisabetta, Arpa, Donatella, Ghigi, Giulia, Fabbri, Lucia, Foca, Flavia, Tontini, Luca, Neri, Elisa, Pieri, Martina, Cima, Simona, Burgio, Marco Angelo, Belli, Maria Luisa, Luzzi, Luca, Romeo, Antonino
Format: Article
Language:English
Subjects:
Acute toxicity
Biopsy
Care and treatment
Chemotherapy
Clinical trials
Dosimetry
Malignancy
Medical imaging
Medical prognosis
Mesothelioma
Methods
Patients
Planning
Pleural diseases
Pneumonectomy
Pneumonitis
Radiation therapy
Radiotherapy
Spirometry
Superinfection
Survival
Toxicity
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Summary:Malignant Pleural Mesothelioma (MPM) is a rare malignancy with an overall poor prognosis. The standard therapeutic strategy in early-stage disease is trimodality therapy. In this publication, we report the preliminary toxicity results of the first 20 patients treated with accelerated hypofractionated radiotherapy. Between July 2017 to June 2019, 20 MPM patients were enrolled and treated with accelerated hypofractionated radiotherapy using helical tomotherapy and intensity-modulated arc therapy. The prescription dose was 30 Gy in five daily fractions, while an inhomogeneous dose escalation to 40 Gy was prescribed based solely upon the presence of gross residual tumor. Only one case of G3 toxicity was reported, which was a bilateral pneumonitis that occurred two years after treatment probably due to superinfection. Median Time to Progression reached 18.2 months while one- and three-year Overall Survival rates were 85% (95% CI:60.4-94.9) and 49.5% (95% CI:26.5-68.9), respectively. Treatment of the intact lung with pleural intensity-modulated arc irradiation is a novel treatment strategy that appears to be safe, feasible, and without a high grade of lung toxicity. Survival rates and Time to Progression are encouraging.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers15041057