The Use of Radiation Therapy for the Treatment of Malignant Pleural Mesothelioma: Expert Opinion from the National Cancer Institute Thoracic Malignancy Steering Committee,International Association for the Study of Lung Cancer,and Mesothelioma Applied Research Foundation |
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Authors: | Daniel R. Gomez Andreas Rimner Charles B. Simone B.C. John Cho Marc de Perrot Alex A. Adjei Raphael Bueno Ritu R. Gill David H. Harpole Mary Hesdorffer Fred R. Hirsch Andrew A. Jackson Harvey I. Pass David C. Rice Valerie W. Rusch Anne S. Tsao Ellen Yorke Kenneth Rosenzweig |
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Affiliation: | 1. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York;2. Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland;3. Cancer Clinical Research Unit, Princess Margaret Cancer Centre, Toronto, Ontario, Canada;4. Department of Oncology, Mayo Clinic, Rochester, Minnesota;5. Division of Thoracic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts;6. Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts;7. Department of Surgery, Duke University School of Medicine, Durham, North Carolina;8. Mesothelioma Applied Research Foundation, Washington, D.C.;9. Department of Medicine, University of Colorado, Denver, Colorado;10. Department of Pathology, University of Colorado, Denver, Colorado;11. The University of Texas Medical School, Houston, Texas;12. Department of Cardiothoracic Surgery, New York University School of Medicine, New York, New York;13. Department of Thoracic and Cardiovascular Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas;14. Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York;15. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas;p. Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York;q. Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York |
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Abstract: | IntroductionDetailed guidelines regarding the use of radiation therapy for malignant pleural mesothelioma (MPM) are currently lacking because of the rarity of the disease, the wide spectrum of clinical presentations, and the paucity of high-level data on individual treatment approaches.MethodsIn March 2017, a multidisciplinary meeting of mesothelioma experts was cosponsored by the U.S. National Cancer Institute, International Association for the Study of Lung Cancer Research, and Mesothelioma Applied Research Foundation. Among the outcomes of this conference was the foundation of detailed, multidisciplinary consensus guidelines.ResultsHere we present consensus recommendations on the use of radiation therapy for MPM in three discrete scenarios: (1) hemithoracic radiation therapy to be used before or after extrapleural pneumonectomy; (2) hemithoracic radiation to be used as an adjuvant to lung-sparing procedures (i.e., without pneumonectomy); and (3) palliative radiation therapy for focal symptoms caused by the disease. We discuss appropriate simulation techniques, treatment volumes, dose fractionation regimens, and normal tissue constraints. We also assess the role of particle beam therapy, specifically, proton beam therapy, for MPM.ConclusionThe recommendations provided in this consensus statement should serve as important guidelines for developing future clinical trials of treatment approaches for MPM. |
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Keywords: | Corresponding author. Address for correspondence: Daniel R. Gomez, MD, Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center 1250 1st Avenue, SM04 New York, NY 10065. Mesothelioma Radiation therapy Consensus guidelines Treatment recommendations |
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