The role of radiotherapy in the treatment of malignant pleural mesothelioma

Clinical Oncology. 2007 Apr;19(3):182-7. Epub 2007 Jan 29. [Link]

Waite K, Gilligan D.

Oncology Centre, Addenbrooke’s Hospital, Hills Road, Cambridge CB2 2QQ, UK.


Radiation therapy for the treatment of malignant pleural mesothelioma has historically been limited by its efficacy. However, the increasing incidence of this tumour and the emergence of new technologies present a number of opportunities and challenges for this treatment modality. Radiotherapy is used to palliate mesothelioma patients with chest wall pain. Responses of over 60% have been seen, although the duration of response is often disappointing. The optimum dose has not been shown and many of the previous studies were small retrospective studies. An improved response has been seen in several studies where hyperthermia was added to radiotherapy. However, further investigation of this technique, which is not widely available, is required. There has not been any comparison of radiotherapy with chemotherapy in the palliation of patients with malignant pleural mesothelioma. Prophylactic chest wall radiotherapy to intervention sites successfully reduces the incidence of malignant seeding along the intervention tracts. However, the optimum dose and timing of treatment are not clear. There is no role for radical radiotherapy alone, but the role of radiotherapy as part of multimodality therapy is discussed. There have been studies of intensity-modulated radiotherapy as part of multimodality therapy and this technique needs to be evaluated further.

Keywords: chemotherapy; Malignant pleural mesothelioma; multimodality treatment; prophylactic radiotherapy; radiotherapy palliation