Prevention of tumour seeding following thoracoscopy in mesothelioma by prophylactic radiotherapy

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.…”

“…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).…”

Drain site radiotherapy in malignant pleural mesothelioma: a wasted resource

“…The standard of care has been to offer prophylactic irradiation following these procedures; however, the evidence that this reduces nodule formation or improves quality of life is questionable. Two studies [2,3] are the basis for our current practice. LOW et al [2] reviewed 20 patients who had received radiotherapy to 38 sites.…”

“…Two studies [2,3] are the basis for our current practice. LOW et al [2] reviewed 20 patients who had received radiotherapy to 38 sites. During follow-up of 1-10 months, none of these patients developed tumour seeding.…”

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

“…Many different hypofractionated radiation treatment schedules have been tested: 8 or 10 Gy in 1 fraction, 16 Gy in 2 fractions, 18 Gy in 3 fractions, 20 Gy in 4 or 5 fractions and 21 Gy in 3 fractions over 1 week (equivalent to 45 Gy in 4,5 weeks). The latter is the most frequently reported in literature and appears to be the most effective [7,11,13,14].…”