Mesothelioma Cancer Publication - Intraoperative Radiation Therapy

This is an abstract of an article about mesothelioma and intraoperative radiation therapy that was published at PubMed by the NIH.

Rosenzweig KE, Fox JL, Zelefsky MJ, Raben A, Harrison LB, Rusch VW.
Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY.
Brachytherapy. 2005;4(1):30-3.

PURPOSE: 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 (192)Ir using a customized applicator with a remote afterloader. A median of 3 sites were treated to a median area of 143 cm(2). 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).

RESULTS: 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.

CONCLUSIONS: 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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