title: Fast neutron radiotherapy in the treatment of malignant pleural mesothelioma.
abstract: BACKGROUND
  Malignant pleural mesothelioma (MPM) is a fatal disease lacking standardized treatment. We describe the use of fast neutron radiation therapy in MPM patients referred to the Department of Radiation Oncology at the University of Washington Medical Center.
  
  
  METHODS
  Retrospective chart review of MPM patients receiving neutron radiotherapy treatment from 1980 to 2012.
  
  
  RESULTS
  A total of 30 MPM patients received fast neutron radiotherapy as part of their treatment regimen. Median age at diagnosis was 59.6 years (range, 46.6 to 72.3 y). Eighteen patients received fast neutron radiotherapy as a component of trimodality treatment. Median overall survival was 20.3 months (range, 5.5 to 73.3 mo) with 1 patient censored at 34.8 months and all other patients with confirmed dates of death. One patient receiving radiotherapy alone as a palliative measure died during radiation treatment. One patient was unable to tolerate radiotherapy and stopped before completing prescribed treatment. On univariate analysis, Brigham Stage at presentation was a significant predictor of survival (P<0.01). No significant differences in survival were observed when comparing patients who received trimodality treatment compared to those who did not.
  
  
  CONCLUSIONS
  Fast neutron radiotherapy may be utilized in the management of MPM patients. However, treatment with fast neutron radiotherapy did not significantly improvement outcome, even when used in a trimodality regimen.
authors.affiliation: *Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA †Department of Otolaryngology, University of California Davis School of Medicine, Sacramento, CA ‡Celilo Radiation Therapy, Mid-Columbia Medical Center, The Dalles, OR.
authors.forename: Shilpen A
authors.initials: SA
authors.lastname: Patel
authors.forename: Aaron S
authors.initials: AS
authors.lastname: Kusano
authors.forename: Anh
authors.initials: A
authors.lastname: Truong
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Stelzer
authors.forename: George E
authors.initials: GE
authors.lastname: Laramore
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D005214:Fast Neutrons / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy* / Q000628:therapy; D008297:Male; D008654:Mesothelioma / Q000532:radiotherapy* / Q000628:therapy; D000086002:Mesothelioma, Malignant; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000532:radiotherapy* / Q000628:therapy; D011013:Pneumonectomy; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D014747:Vinblastine; D016190:Carboplatin; D002945:Cisplatin; D008727:Methotrexate