Abstract
Purpose
To report results of a phase II trial of high-dose-rate intra-operative radiation
therapy (HDR-IORT) for malignant pleural mesothelioma (MPM).
Methods and materials
Seven patients had extrapleural pneumonectomy with IORT (EPP/IORT) and 6 patients
had pleurectomy/decortication with IORT (PD/IORT) between 1994 and 1996. IORT was
delivered with 192Ir using a customized applicator with a remote afterloader. A median of 3 sites were
treated to a median area of 143 cm2. A dose of 1500 cGy was prescribed at each site, with 1000 cGy delivered to the mediastinum.
Postoperative external beam radiation therapy (EBRT) was given 3–5 weeks later. Median
follow-up was 8 months (range, 1–84 months).
Results
Five patients developed local failure. Two-year local control and survival rates were
35% and 23%, respectively. Mortality was 2/13 (15%), 1 from each surgical group. Serious
complications requiring further intervention occurred in 3/6 (50%) of the EPP/IORT
group and 1/5 (20%) of the PD/IORT group.
Conclusions
HDR-IORT after EPP for MPM is prohibitively toxic and has been abandoned, while its
use with PD remains in question.
Keywords
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Article info
Publication history
Accepted:
October 18,
2004
Received in revised form:
August 18,
2004
Received:
May 4,
2004
Identification
Copyright
© 2005 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
