The Use of Radiation Therapy for the Treatment of Malignant Pleural Mesothelioma: Expert Opinion from the National Cancer Institute Thoracic Malignancy Steering Committee, International Association for the Study of Lung Cancer, and Mesothelioma Applied Research Foundation

Daniel R. Gomez, Andreas Rimner, Charles B. Simone, B. C.John Cho, Marc de Perrot, Alex Adjei, Raphael Bueno, Ritu R. Gill, David H. Harpole, Mary Hesdorffer, Fred R. Hirsch, Andrew A. Jackson, Harvey I. Pass, David C. Rice, Valerie W. Rusch, Anne S. Tsao, Ellen Yorke, Kenneth Rosenzweig

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

Introduction: Detailed guidelines regarding the use of radiation therapy for malignant pleural mesothelioma (MPM) are currently lacking because of the rarity of the disease, the wide spectrum of clinical presentations, and the paucity of high-level data on individual treatment approaches. Methods: In March 2017, a multidisciplinary meeting of mesothelioma experts was cosponsored by the U.S. National Cancer Institute, International Association for the Study of Lung Cancer Research, and Mesothelioma Applied Research Foundation. Among the outcomes of this conference was the foundation of detailed, multidisciplinary consensus guidelines. Results: Here we present consensus recommendations on the use of radiation therapy for MPM in three discrete scenarios: (1) hemithoracic radiation therapy to be used before or after extrapleural pneumonectomy; (2) hemithoracic radiation to be used as an adjuvant to lung-sparing procedures (i.e., without pneumonectomy); and (3) palliative radiation therapy for focal symptoms caused by the disease. We discuss appropriate simulation techniques, treatment volumes, dose fractionation regimens, and normal tissue constraints. We also assess the role of particle beam therapy, specifically, proton beam therapy, for MPM. Conclusion: The recommendations provided in this consensus statement should serve as important guidelines for developing future clinical trials of treatment approaches for MPM.

Original languageEnglish (US)
Pages (from-to)1172-1183
Number of pages12
JournalJournal of Thoracic Oncology
Volume14
Issue number7
DOIs
StatePublished - Jul 1 2019

Keywords

  • Consensus guidelines
  • Mesothelioma
  • Radiation therapy
  • Treatment recommendations

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

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    Gomez, D. R., Rimner, A., Simone, C. B., Cho, B. C. J., de Perrot, M., Adjei, A., Bueno, R., Gill, R. R., Harpole, D. H., Hesdorffer, M., Hirsch, F. R., Jackson, A. A., Pass, H. I., Rice, D. C., Rusch, V. W., Tsao, A. S., Yorke, E., & Rosenzweig, K. (2019). The Use of Radiation Therapy for the Treatment of Malignant Pleural Mesothelioma: Expert Opinion from the National Cancer Institute Thoracic Malignancy Steering Committee, International Association for the Study of Lung Cancer, and Mesothelioma Applied Research Foundation. Journal of Thoracic Oncology, 14(7), 1172-1183. https://doi.org/10.1016/j.jtho.2019.03.030