This study compared the outcomes after moderate-dose radiotherapy and high-dose radiotherapy after extra-pleural pneumonectomy for malignant pleural mesothelioma.
Between July 1994 and April 2004, 39 patients underwent EPP and adjuvant RT at Dana-Farber Cancer Institute/Brigham and Women’s Hospital.
A total of 39 patients underwent RT after EPP. The median age was 59 years (range, 44-77). The histologic type was epithelial in 25 patients (64%) and mixed or sarcomatoid in 14 patients (36%). Of the 39 patients, 24 underwent moderate dose radiotherapy and 15 (39%) high dose radiotherapy. The median follow-up was 23 months (range, 6-71). The median overall survival was 19 months (95% confidence interval, 14-24). The median time to distant failure and local failure was 20 months (95% confidence interval, 14-26) and 26 months (95% confidence interval, 16-36), respectively. The radiotherapy technique was not predictive of survival.
High-dose hemithoracic raditotherapy appears to limit in-field local failure compared with moderate dose radiotherapy. However, distant failure remains a significant challenge, with one-half of our patients experiencing distant failure.
From PubMed: Int J Radiat Oncol Biol Phys. 2007 Aug 1;68(5):1366-1374; Influence of Radiotherapy Technique and Dose on Patterns of Failure for Mesothelioma Patients After Extrapleural Pneumonectomy; Allen AM, Den R, Wong JS, Zurakowski D, Soto R, Jänne PA, Zellos L, Bueno R, Sugarbaker DJ, Baldini EH., Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA; Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, MA.
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