Prevention of Malignant Seeding After Invasive Diagnostic Procedures in Patients With Pleural Mesothelioma

A randomised trial of single-dose radiotherapy to prevent procedure tract metastasis by malignant mesothelioma

“…The French nonrandomised series and subsequent randomised trial used higher energy 12 -15 MeV electrons (Boutin and Rey, 1993;Boutin et al, 1995), while the British study employed 140-or 250-kV photons (Low et al, 1995). These alternative radiations give a higher dose beyond approximately 3 cm depth in tissue.…”

“…Chest wall seeding following invasive procedures is a problem, and has been reported to occur in 19% of patients following thoracoscopy (Boutin et al, 1995). These subcutaneous masses are often symptomatic and refractory to radiotherapy (RT) (Davis et al, 1994).…”

“…These subcutaneous masses are often symptomatic and refractory to radiotherapy (RT) (Davis et al, 1994). Two nonrandomised series and one randomised controlled trial have demonstrated that a prophylactic three-fraction course of RT reduces the procedure tract metastasis rate to 0% (Boutin and Rey, 1993;Boutin et al, 1995;Low et al, 1995). Recent reviews and guidelines recommended prophylactic radiotherapy following thoracic procedures (BTSSCC, 2001;Parker and Neville, 2003).…”

Prevention of malignant seeding at drain sites after invasive procedures (surgery and/or thoracoscopy) by hypofractionated radiotherapy in patients with pleural mesothelioma

“…On the back, these lesions are particularly uncomfortable and often prevent patients from sleeping. In the presence of seeding metastases, surgical resection, when feasible, is the only effective procedure and radiotherapy is often ineffective [7,9].…”

“…In the literature, the mean incidence of malignant seeding from pleural mesothelioma is 19% ranging from 2 to 51% [7,10]. In the attempt of preventing that, radiotherapy has been used in a few retrospective and prospective clinical trials with non univocal results: tumour seeding ranged from 0 to 48% (Table I) [7,11Á15].…”