Original articleGeneral thoracicOutcomes After Extrapleural Pneumonectomy and Intensity-Modulated Radiation Therapy for Malignant Pleural Mesothelioma
Section snippets
Material and Methods
The study was approved by the Institutional Review Board at the University of Texas M. D. Anderson Cancer Center and waiver of individual informed consent was granted. We included all patients who had a diagnosis of malignant pleural mesothelioma and who were treated with extrapleural pneumonectomy between October 1999 and July 2005 at the University of Texas M. D. Anderson Cancer Center. Patients were radiographically staged with computed tomography (CT [n = 100]) and positron emission
Demographics
From October 1999 through July 2005, 100 consecutive patients underwent EPP. There were 14 women (14%), and the mean age at the time of surgery was 60 years (range, 37 to 80). Tumors were right-sided in 66 patients (66%) and were epithelioid in 67 (67%), biphasic in 24 (24%), and sarcomatoid in 9 (9%), as shown in Table 1. Postsurgical (or pathologic) stage was Ib in 6 patients (6%), II in 7 (7%), III in 72 (72%), and IV in 15 (15%). With the exception of a single patient who was found to have
Comment
Local failure remains a significant problem after EPP despite adjuvant radiation. Baldini and colleagues [4] reported patterns of failure in 35 patients who underwent trimodality treatment with EPP, chemotherapy, and radiation therapy (median dose 30.6 Gy). Local recurrence occurred in 31% of patients and did not appear to be influenced by histology, nodal, or margin status. Subsequently, Rusch and coworkers [18] prospectively evaluated the use of higher dose (54 Gy) adjuvant radiation after
References (26)
- et al.
Important prognostic factors in patients with malignant pleural mesothelioma, managed surgically
Ann Thorac Surg
(1999) - et al.
Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients
J Thorac Cardiovasc Surg
(1999) - et al.
Hemithoracic radiation after extrapleural pneumonectomy for malignant pleural mesothelioma
J Radiat Oncol Biol Phys
(2003) - et al.
Dose, volume, and function relationships in parotid salivary glands following conformal and intensity-modulated irradiation of head and neck cancer
Int J Radiat Oncol Biol Phys
(1999) - et al.
Clinical experience with intensity modulated radiation therapy (IMRT) in prostate cancer
Radiother Oncol
(2000) - et al.
Intensity-modulated radiation therapy: a novel approach to the management of malignant pleural mesothelioma
Int J Radiat Oncol Biol Phys
(2003) - et al.
Intensity-modulated radiotherapy following extrapleural pneumonectomy for the treatment of malignant mesothelioma: clinical implementation
Int J Radiat Oncol Biol Phys
(2003) - et al.
V20 predicts fatal pulmonary toxicity after extrapleural pneumonectomy and intensity modulated radiation therapy [Abstract]
Int J Radiat Oncol Biol Phys
(2006) - et al.
Dose-dependant pulmonary toxicity after postoperative intensity-modulated radiotherapy for malignant pleural mesothelioma
Int J Radiat Oncol Biol Phys
(2007) - et al.
A phase II trial of surgical resection and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma
J Thorac Cardiovasc Surg
(2001)
The effect of extent of local resection on patterns of disease progression in malignant pleural mesothelioma
Ann Thorac Surg
Long-term survival after non-small cell lung cancer surgery: development and validation of a prognostic model with a preoperative and postoperative mode
J Thorac Cardiovasc Surg
Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma
Int J Radiat Oncol Biol Phys
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