Stereotactic Intensity-Modulated Radiation Therapy (IMRT) and Inverse Treatment Planning for Advanced Pleural Mesothelioma

Münter, Marc W.; Nill, Simeon; Thilmann, Christoph; Hof, Holger; Höss, Angelika; Häring, Peter; Partridge, M.; Manegold, Christian; Wannenmacher, M; Debus, Jürgen

doi:10.1007/s00066-003-1055-7

Cited by 40 publications

(25 citation statements)

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“…The purpose was to explore the potential of tomotherapy as a new method of image-guided intensity-modulated radiotherapy (IMRT) to lower the dose to kidneys, liver and bone marrow while covering the peritoneal cavity with a homogeneous dose [8,15,16,23,24]. With a field width of 40 cm and a maximal length of 160 cm, helical tomotherapy is a very promising option for this kind of large and complexly shaped target volumes [1,2,6,10,12,17,19]. We provide the first clinical report on the use of tomotherapy in large-field WAI.…”

Section: Introductionmentioning

confidence: 99%

Helical Tomotherapy as a New Treatment Technique for Whole Abdominal Irradiation

et al. 2008

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Section: Introductionmentioning

confidence: 99%

Helical Tomotherapy as a New Treatment Technique for Whole Abdominal Irradiation

et al. 2008

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“…Further attempts at improving local control with radiotherapy after EPP have focused on intensity modulated radiotherapy (IMRT), initially in the curative setting at MD Anderson [10,11] and in the palliative setting in Heidelberg [12]. See Table 1.…”

Section: Intensity Modulated Radiotherapymentioning

confidence: 99%

What Is the Role of Radiotherapy in Malignant Pleural Mesothelioma?

Price

2011

The Oncologist

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Objective. A review of the evidence supporting the use of radiotherapy in patients with mesothelioma was performed.Methods. Relevant publications were searched for on Medline.Results. In a Medline search on radiotherapy and mesothelioma, 611 hits were obtained. A limited number of prospective phase II trials of radiotherapy as part of trimodality protocols for early disease and in the palliation of pain were found, along with three small randomized controlled trials of port-site prophylaxis.Conclusion. No randomized data exist to support the use of radiotherapy after radical surgery, although there are a large number of publications describing its use as an integral part of therapy, including seven phase II studies. One ongoing trial is randomizing patients to radiotherapy or not after extrapleural pneumonectomy. None of these studies provided any assessment of radiotherapy independent of the other modalities investigated, nor did any formally assess intensity-modulated radiotherapy. There have been several reports of excessive toxicity with this technique, and its use should be limited to phase I studies until the basis of this toxicity is better understood. Three trials have looked at port-site prophylaxis, one supporting its use and two showing no evidence of benefit. Two studies addressed pain control prospectively, one showing definite but short-lived benefits.Implications. Radiotherapy is widely used in treating mesothelioma with little supporting evidence. More randomized trials are required to justify this use in all three common settings for its use. The Oncologist 2011; 16:359 -365

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“…The authors reported that radical surgery in the form of EPP within trimodal therapy offers no benefit for survival or quality of life [20]. Several studies evaluated the potential role of adjuvant RT in MPM [4,6,19]; however, to date there has been limited reported experience in the feasibility of dose escalation with IMRT for unresectable MPM [21,22]. In our study, for the first time, we demonstrated from a dosimetric/radiobiological point of view the potential of HT to selectively increase the dose to high-risk areas detected by 18 lung DVH values from patient-specific treatment simulation CT data may be a valid approach for better understanding, before planning preparation, the adequate patient-specific planning strategies associated with an acceptable lung dose.…”

Section: Discussionmentioning

confidence: 99%