Hemithoracic Intensity Modulated Radiation Therapy After Pleurectomy/Decortication for Malignant Pleural Mesothelioma: Toxicity, Patterns of Failure, and a Matched Survival Analysis

Accelerated hemithoracic radiation followed by extrapleural pneumonectomy for malignant pleural mesothelioma

“…Despite the use of intraoperative therapy, EPD remains associated with a high rate of local recurrence compared with EPP, and some centers have begun to explore the possibility of adjuvant hemithoracic radiation after EPD to improve local control. [21][22][23] This strategy has been associated with a risk of severe pneumonitis, however, and contributes to a decline in function of the preserved lung. 22,24 The present study has some inherent limitations related to its design as a single-center trial with a single treatment arm.…”

Early experience with intensity modulated proton therapy for lung-intact mesothelioma: A case series

“…A comprehensive review of our IMRT experience has been published previously. 5 Six patients had undergone P/D, and the seventh had only biopsy because of nodal involvement. All patients received cisplatin and pemetrexed.…”

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

“…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).…”

“…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.…”

“…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].…”