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).
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.
HDR-IORT after EPP for MPM is prohibitively toxic and has been abandoned, while its use with PD remains in question.
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- Treatment of intervention sites of malignant pleural mesothelioma with radiotherapy: A Dutch-Belgian survey.Radiother Oncol. 2003; 68: 299-302
- A phase II trial of surgical resection and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma.J Thorac Cardiovasc Surg. 2001; 122: 788-795
- Pleurectomy and intraoperative brachytherapy and postoperative radiation in the treatment of malignant pleural mesothelioma.Int J Radiat Oncol Biol Phys. 1984; 10: 325-331
- Radical pleurectomy/decortication and intraoperative radiotherapy followed by conformal radiation with or without chemotherapy for malignant pleural mesothelioma.J Thorac Cardiovasc Surg. 2002; 124: 1183-1189
- Results of treatment of malignant pleural mesothelioma with surgery, brachytherapy, and external beam irradiation.Endocurie Hypertherm Oncol. 1989; 5 (Abstr.): 245
- Phase II trial of combined surgical resection, high dose rate intraoperative radiation therapy, and external beam radiotherapy for malignant pleural mesothelioma.Int J Radiat Oncol Biol Phys. 1997; 39: 316
- Mesothelioma and less common tumors.in: Pearson F.G. Cooper J.D. Deslauriers J. Ginsberg R.J. Thoracic surgery. 2nd ed. WB Saunders, Philadelphia2000: 1241-1263
- Brachytherapy for non-small cell lung cancer and selected neoplasms of the chest.Chest. 1997; 112: 276S-286S
Accepted: October 18, 2004
Received in revised form: August 18, 2004
Received: May 4, 2004
© 2005 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.