Adjuvant radiotherapy after extrapleural pneumonectomy for mesothelioma. Prospective analysis of a multi-institutional series

Radiother Oncol. 2011 Nov;101(2):311-5. doi: 10.1016/j.radonc.2011.09.025. Epub 2011 Nov 11.


Background and purpose: To evaluate survival, locoregional control and toxicity in a series of 56 mesothelioma patients treated from May 2005 to May 2010 with post-operative radiotherapy after extrapleural pneumonectomy (EPP) in three Italian Institutions (Brescia, Florence, and Modena).

Material and methods: Fifty-six patients treated with adjuvant radiotherapy (RT) after EPP were analyzed. Four patients were treated with 3DCRT, 50 with IMRT and two with helical tomotherapy. Forty-five to 50 Gy in 25 fractions were given to the affected hemithorax and to ipsilateral mediastinum, with a simultaneous integrated boost to the sites of microscopically involved margins up to 60 Gy in 20/56 cases.

Results: Three year locoregional control (LRC), distant metastasis free (DMF), disease free (DF), disease specific (DSS) and overall survival (OS) rates are 90%, 66%, 57%, 62%, and 60%, respectively.

Conclusion: Postoperative RT with modern techniques is an effective method to obtain excellent local control and cure rates in mesothelioma patients submitted to EPP.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Heart / radiation effects
  • Humans
  • Italy
  • Kidney / radiation effects
  • Liver / radiation effects
  • Male
  • Mesothelioma / pathology
  • Mesothelioma / radiotherapy*
  • Mesothelioma / surgery
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Pleural Neoplasms / pathology
  • Pleural Neoplasms / radiotherapy*
  • Pleural Neoplasms / surgery
  • Pneumonectomy / methods*
  • Prospective Studies
  • Radiotherapy Dosage
  • Radiotherapy, Adjuvant
  • Survival Rate
  • Treatment Outcome