Prophylactic radiotherapy to intervention sites in malignant pleural mesothelioma - Single-institution experience and literature review

Aim: To evaluate the efficacy of prophylactic radiotherapy at intervention sites in patients with malignant pleural mesothelioma (MPM). Patients and Methods: From 05/2010 to 12/2014, 53 patients with histologically confirmed MPM were treated in order to prevent interventional site metastases. Irradiation was carried out with 3×7=21 Gy with 6-18 MeV electrons. Results: The mean follow-up period was 14.4 months (range=0-37 months). At the time of the analysis, 20 patients were alive. Three patients had developed a local recurrence within the irradiated site, representing a local recurrence rate of 5.7%. Toxicity was low, with transient grade I erythema found in 20.7% of patients. No grade II or higher toxicity was observed. Conclusion: Our simple and time-saving RT approach to interventional sites in patients with MPM was both effective and well-tolerated. This approach is easily integrated into general treatment concepts. Until publication of results from prospective randomized trials, prophylactic RT to intervention sites should remain standard.