Adjuvant radiotherapy for malignant pleural mesothelioma: challenges and pitfalls

Our plain-English summary of Adjuvant radiotherapy for malignant pleural mesothelioma: challenges and pitfalls, by G.L. Ceresoli, U. Ricardi, V. Vavassori, et al (Radiotherapy and Oncology, 2012).

The study

• Authors: G.L. Ceresoli, U. Ricardi, V. Vavassori, M. Scorsetti
• Journal: Radiotherapy and Oncology
• Published: 2012;105(2):271
• Type of article: Letter, Comment
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor, not a research study. The authors commented on an earlier article by Tonoli et al. about radiotherapy given after extrapleural pneumonectomy in patients with malignant pleural mesothelioma. The letter authors argued that Tonoli et al. should tone down their conclusion that this radiotherapy gives excellent local control and cure rates. They said the patients in that series reflected strict selection. Patients came from three institutions, and two of them included fewer than one patient per year. Patients had almost exclusively epithelial tumors. Their median age was 57.8 years, compared with a median age at diagnosis of 68 years in the general malignant pleural mesothelioma population in Italy. In that series, 55.4% had lymph node negative disease. Chemotherapy varied, and nearly one third of patients received hyperthermic intrapleural chemotherapy during surgery. The letter noted that severe toxicities in that series were uncommon, but two treatment-related deaths occurred. The authors concluded that Tonoli et al.'s high survival rates were achieved in a clearly selected population. The letter did not discuss asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor commenting on a previously published study (Tonoli et al.); no original data
• Who was studied: No population was studied by the letter authors. The letter discusses the patient series reported by Tonoli et al.: patients with malignant pleural mesothelioma treated with extrapleural pneumonectomy and post-operative radiotherapy at three institutions
• Exposure: Treatment discussed, not asbestos exposure: post-operative radiotherapy after extrapleural pneumonectomy, as reported by Tonoli et al.
• Main results:
  • The letter authors argued that Tonoli et al.'s data reflect strict patient selection rather than a defined treatment protocol
  • The letter states that, of the three institutions in Tonoli et al.'s series, two included fewer than one patient per year
  • The letter states that patients in Tonoli et al.'s series had almost exclusively epithelial histology
  • The letter states that patients in Tonoli et al.'s series had a median age of 57.8 years. This is younger than the general malignant pleural mesothelioma population in Italy, whose median age at diagnosis is 68 years
  • The letter states that 55.4% of patients in Tonoli et al.'s series had lymph node negative disease at pathological examination
  • The letter states that chemotherapy in Tonoli et al.'s series was heterogeneous
  • The letter states that nearly one third of cases in Tonoli et al.'s series received hyperthermic intrapleural chemotherapy at surgery
  • The letter states that severe acute and late toxicities in Tonoli et al.'s series were uncommon, but two treatment-related deaths occurred
• The authors' conclusion: The authors concluded that Tonoli et al.'s data support the feasibility of post-operative radiotherapy with relatively low toxicity. In their view, however, the high survival rates were achieved in a clearly selected population

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma.

Related studies

• In reply to L. Ceresoli et al. "Adjuvant radiotherapy for malignant pleural mesothelioma: challenges and pitfalls" — S. Tonoli, S. Magrini, et al. (2012)
• Adjuvant radiotherapy after extrapleural pneumonectomy for mesothelioma. Prospective analysis of a multi-institutional series — S. Tonoli, P. Vitali, et al. (2011)
• Induction chemotherapy, extrapleural pneumonectomy, and adjuvant radiotherapy for malignant pleural mesothelioma: experience of Guy's and St Thomas' hospitals — A. Bille, E. Belcher, et al. (2012)
• The Role of Adjuvant Radiotherapy in the Treatment of Pleural Mesothelioma — G.D. Lewis, S.M. Dalwadi, et al. (2019)
• Pattern of failure after adjuvant radiotherapy following extrapleural pneumonectomy of pleural mesothelioma in the SAKK 17/04 trial — O. Riesterer, I.F. Ciernik, et al. (2019)
• High-dose-rate surface brachytherapy to boost elongated, curvilinear incisional scars after extrapleural pneumonectomy for malignant pleural mesothelioma treated with adjuvant intensity-modulated radiation therapy — L.A. Doyle, T.N. Showalter, et al. (2010)

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