Patients with malignant pleural mesothelioma who underwent nonradical surgery and chemotherapy appeared twice as likely to achieve 2-year OS with radical hemithoracic radiotherapy vs. palliative radiotherapy, according to randomized phase 3 study results presented at European Society for Radiotherapy and Oncology Congress.
Based on these findings, the researchers recommended consideration of radical hemithoracic radiotherapy — which also demonstrated acceptable toxicity — as the new standard of care for these patients.
“Patients with mesothelioma are sometimes given radiotherapy to help control their symptoms,” Marco Trovo, MD, chief of the radiation oncology department at University Hospital of Udine in Italy, said in a press release. “However, radiotherapy has evolved dramatically in the last few years, so we wanted to see if it could now be used to prevent the cancer from spreading to nearby tissue, hopefully bringing improvements in survival.”
Trovo and colleagues evaluated 108 patients treated between 2014 and 2018 at the National Cancer Institute of Aviano, Italy. Participants had received nonradical lung-sparing surgery and platinum-pemetrexed chemotherapy. Researchers based eligibility upon factors including PET staging, presence of gross residual disease after surgery, and technical possibility of high-dose hemithoracic radiotherapy delivery. Contralateral mediastinal lymph node metastasis and intrascissural disease served as exclusion criteria.
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