The role of radiation therapy in malignant pleural mesothelioma: a systematic review.
BACKGROUND
Radiation therapy may offer patients presenting with malignant pleural mesothelioma (MPM) symptom palliation and improvements in quality of life. This systematic review will address the role of radiation therapy in the management of MPM.


METHODS
A thorough systematic search of the literature was conducted for published articles and conference proceedings for applicable abstracts. Relevant trials were selected and assessed.


RESULTS
Three small randomized controlled trials compared prophylactic external beam radiation therapy to no radiation therapy for patients with thoracic tracts caused by drainage tubes or diagnostic procedures. None of those trials reported any serious adverse effects. A pooled analysis found no significant reduction in the frequency of procedure tract metastases. Four non-comparative studies have shown that hemithoracic irradiation alone resulted in significant toxicity, including radiation-induced pulmonary fibrosis, radiation pneumonitis, and bronchopleural fistula, without any survival benefit. Few of the identified studies reported on symptom control, and no studies included formal measures of quality of life.


CONCLUSIONS
There is limited evidence for the role of radiotherapy in the management of patients with MPM. Future studies including radiotherapy for the treatment of such patients should include formal measures of quality of life and symptom control.
Ung
Yee C
YC
Toronto-Sunnybrook Regional Cancer Centre, Toronto, ON, Canada. vanderja@mcmaster.ca
Yu
Edward
E
Falkson
Conrad
C
Haynes
Adam E
AE
Stys-Norman
Denise
D
Evans
William K
WK
D002986:Clinical Trials as Topic; D016206:Databases, Bibliographic; D006801:Humans; D008654:Mesothelioma / Q000401:mortality / Q000532:radiotherapy*; D010997:Pleural Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D011446:Prospective Studies; D011788:Quality of Life; D018787:Radiation Oncology / Q000379:methods; D011878:Radiotherapy / Q000009:adverse effects*; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome