Tomotherapy after pleurectomy or decortication or biopsy for malignant pleural mesothelioma

Our plain-English summary of Tomotherapy after pleurectomy or decortication or biopsy for malignant pleural mesothelioma, by M. Trovo, E. Minatel (Journal of Thoracic Oncology, 2013).

The study

• Authors: M. Trovo, E. Minatel
• Journal: Journal of Thoracic Oncology
• Published: 2013;8(5):e50-1
• Type of article: Letter, Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This item was a letter to the editor. In it, the authors replied to a letter from Bölükbas and colleagues about the authors' earlier article on tomotherapy, a form of radiation therapy, given after pleurectomy/decortication or biopsy for malignant pleural mesothelioma. Bölükbas and colleagues had asked why survival and patterns of treatment failure were not reported. The authors gave two reasons. First, the earlier article focused on the safety of very high radiation doses to an intact lung: 25 of 28 patients received 60 Gy in 25 fractions. The authors noted that this work had found that a dose measure for the opposite lung, called contralateral lung V5, was strongly correlated with the risk of pneumonitis. Second, in the authors' opinion, a median follow-up of 19 months was not enough to draw conclusions on survival. They reported that updated results, with a median follow-up of 27 months, were being submitted to a radiation oncology meeting. For patients who underwent radical pleurectomy/decortication, estimated overall survival was 70% at 2 years and 49% at 3 years.

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 (authors' reply to a letter about their earlier article)
• Who was studied: 28 patients with malignant pleural mesothelioma with an intact lung, treated with tomotherapy after pleurectomy/decortication or biopsy, as reported in the authors' earlier article (Centro di Riferimento Oncologico, Aviano, Italy)
• Exposure: No asbestos exposure was discussed. The subject was high-dose radiation therapy (tomotherapy) to the intact lung; 25 of 28 patients received 60 Gy in 25 fractions.
• Main results:
  • In the earlier article, contralateral lung V5 (a radiation dose measure for the opposite lung) was strongly correlated with the risk of pneumonitis.
  • Updated results at a median follow-up of 27 months were being submitted to the American Society for Radiation Oncology annual meeting.
  • For patients who underwent radical pleurectomy/decortication, estimated overall survival was 70% at 2 years and 49% at 3 years.
• The authors' conclusion: The authors held that a median follow-up of 19 months was not enough to draw conclusions on survival, and that robust data are needed before radical pleurectomy/decortication plus high-dose radiation could be introduced as an alternative treatment option.
• Limitations the authors state:
  • The authors stated that with a median follow-up of 19 months they could show survival results only at 1 and 2 years, which they felt could generate enthusiasm for illusory results.

Topics

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

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

Related studies

• Tomotherapy after pleurectomy/decortication or biopsy for malignant pleural mesothelioma allows the delivery of high dose of radiation in patients with intact lung — E. Minatel, M. Trovo, et al. (2012)
• Tomotherapy after pleurectomy or decortication or biopsy for malignant pleural mesothelioma — S. Bölükbas, J. Schirren, et al. (2013)
• High dose irradiation after pleurectomy/decortication or biopsy for pleural mesothelioma treatment — E. Parisi, A. Romeo, et al. (2017)
• Mesothelioma at era of helical tomotherapy: results of two institutions in combining chemotherapy, surgery and radiotherapy — A. Sylvestre, M.A. Mahé, et al. (2011)
• Extrapleural pneumonectomy or pleurectomy/decortication for malignant pleural mesothelioma — S. Hasegawa (2014)
• Dosimetric Comparison Between Helical Tomotherapy and Volumetric Modulated Arc Therapy in Patients With Malignant Pleural Mesothelioma — T. Müdder, G.R. Sarria, et al. (2022)

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