title: Radiotherapy for the treatment of pain in malignant pleural mesothelioma: a systematic review.
abstract: Radiotherapy is commonly used to treat pain in malignant pleural mesothelioma (MPM). The purpose of this systematic review is to examine the evidence for this practice. Medline (1946-2013), Embase (1974-2013) and Central (The Cochrane Library Issue 9, 2012) databases were searched. Eligible studies met the following criteria: MPM (histological or radiological diagnosis), radiotherapy given with the intent of improving pain, response rates to radiotherapy reported, dose and fractionation reported and the relationship between radiotherapy and pain response explored. All studies had independent review and were graded according to evidence level. Eight studies met the eligibility criteria. Two studies were prospective single arm phase II studies while the remainder were retrospective case series. All were graded as either Level 2 or Level 3 evidence. Due to marked heterogeneity among studies, quantitative synthesis of results was not possible. No high quality evidence currently exists to support radiotherapy in treating pain in MPM. Studies focusing on clear pain endpoints and improving target delineation are needed. Such studies should also use modern radiotherapy techniques and concentrate on dose escalation.
authors: Edinburgh Cancer Research UK Centre, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK; Beatson West of Scotland Cancer Centre, 1053 Great Western Rd, Glasgow G12 0YN, UK. Electronic address: Nicholas.macleod@ggc.scot.nhs.uk.
authors: N
authors: N
authors: Macleod
authors: Edinburgh Cancer Research UK Centre, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK; Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK.
authors: A
authors: A
authors: Price
authors: Beatson West of Scotland Cancer Centre, 1053 Great Western Rd, Glasgow G12 0YN, UK.
authors: N
authors: N
authors: O'Rourke
authors: Edinburgh Cancer Research UK Centre, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK; Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK.
authors: M
authors: M
authors: Fallon
authors: Edinburgh Cancer Research UK Centre, University of Edinburgh, Crewe Road South, Edinburgh EH4 2XR, UK; Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK; Beatson West of Scotland Cancer Centre, 1053 Great Western Rd, Glasgow G12 0YN, UK.
authors: B
authors: B
authors: Laird
mesh_terms: D002985:Clinical Protocols; D002986:Clinical Trials as Topic; D019583:Dose Fractionation, Radiation; D019317:Evidence-Based Medicine; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000532:radiotherapy*; D008654:Mesothelioma / Q000150:complications / Q000532:radiotherapy*; D000086002:Mesothelioma, Malignant; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010997:Pleural Neoplasms / Q000150:complications / Q000532:radiotherapy*
keywords: Malignant; Mesothelioma; Pain; Pleural; Radiotherapy; Treatment