title: Is Radiotherapy Useful for Treating Pain in Mesothelioma?: A Phase II Trial.
abstract: BACKGROUND
  Radiotherapy is often used to treat pain in malignant pleural mesothelioma (MPM), although there is limited evidence to support this. The aim of this trial was to assess the role of radiotherapy for the treatment of pain in MPM.
  
  
  METHODS
  A multicentre, single arm phase II trial was conducted. Eligible patients fulfilled the following criteria: pathological or radiological diagnosis of MPM; pain secondary to MPM; radiotherapy indicated for pain control; and more than 18 years of age. Patients had assessments of pain and other symptoms at baseline and then received 20 Gy in five daily fractions. Key follow-up points were 5 and 12 weeks posttreatment. The primary end point measure was assessment of pain at the site of radiotherapy at 5 weeks. Secondary end points included effects on quality of life, breathlessness, fatigue, mood, toxicity, and the radiological response.
  
  
  RESULTS
  Forty patients were recruited from three UK oncology centers. Fourteen patients had a clinically meaningful improvement in their pain 5 weeks post radiotherapy (intention to treat), with five patients having a complete improvement. On the basis of a complete case analysis of the 30 patients assessable at week 5, 47% (confidence intervals, 28.3-65.7) of patients alive at week 5 had an improvement in their pain. There was no improvement in other key symptoms or quality of life.
  
  
  CONCLUSIONS
  Radiotherapy for pain control in MPM is an effective treatment in a proportion of patients. Future studies examining differing radiotherapy regimens with a view to improving response rates are warranted.
authors: *Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, United Kingdom; †Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom; ‡University of Glasgow, Glasgow, United Kingdom; and §European Palliative Care Research Centre, Norwegian University of Science and Technology, Trondheim, Norway.
authors: Nicholas
authors: N
authors: MacLeod
authors: Anthony
authors: A
authors: Chalmers
authors: Noelle
authors: N
authors: O'Rourke
authors: Karen
authors: K
authors: Moore
authors: Jonathan
authors: J
authors: Sheridan
authors: Lynn
authors: L
authors: McMahon
authors: Caroline
authors: C
authors: Bray
authors: Jon
authors: J
authors: Stobo
authors: Alan
authors: A
authors: Price
authors: Marie
authors: M
authors: Fallon
authors: Barry J
authors: BJ
authors: Laird
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000532:radiotherapy*; D008297:Male; D008654:Mesothelioma / Q000150:complications / Q000532:radiotherapy*; D000086002:Mesothelioma, Malignant; D010146:Pain / Q000209:etiology / Q000532:radiotherapy*; D011788:Quality of Life; D016896:Treatment Outcome