Tomotherapy after Pleurectomy/Decortication or Biopsy for Malignant Pleural Mesothelioma Allows the Delivery of High Dose of Radiation in Patients with Intact Lung

Abstract

Tomotherapy allows the safe delivery of high dose of radiation to the hemithorax of MPM patients with intact lung.

Optimal gross tumor volume definition in lung-sparing intensity modulated radiotherapy for pleural mesothelioma: an in silico study

“…The clinical target volume (CTV) consisted of the whole pleural space, contoured from the lung apex to the diaphragm insertion (T12-L2). Median doses to the planning target volume ranged from 47 to 50 Gy [10][11][12][13][14][15][16]. In all cases, PET/CT was frequently (but not routinely) used to modify the CTV, with the inclusion of any FDG-avid area.…”

“…In all published experiences of lung-sparing IMRT in MPM, irradiation of the whole pleura has been performed [10][11][12][13][14][15][16]. The clinical target volume (CTV) consisted of the whole pleural space, contoured from the lung apex to the diaphragm insertion (T12-L2).…”

“…Lung-sparing intensity modulated radiation therapy (IMRT) (alone or after P/D) has been proven feasible and safe [10][11][12][13][14][15][16].…”

The role of radical radiotherapy in the management of malignant pleural mesothelioma: A systematic review

“…[66–68] Daily image guidance aided the accurate delivery of 50Gy in 25 fractions to the PTV, while areas of FDG avidity were simultaneously boosted to 60Gy. Early safety data from a prospective study of 28 patients who had undergone PD (71%) or biopsy only (29%) were encouraging, with no fatal respiratory toxicities, and only 7% of the cohort developing grade 3 pneumonitis within 5 months of treatment, the incidence of which strongly correlated with contralateral lung V5.…”

Malignant pleural mesothelioma: adjuvant therapy with radiation therapy

“…A n o t h e r s t u d y r e p o r t e d o n t h e u s e o f h e l i c a l tomotherapy after P/D or biopsy alone (24). A total of 28 patients were treated to an intended dose of 50 Gy.…”