RADIATION THERAPY IN MULTIMODAL TREATMENT OF PATIENTS WITH PLEURAL MESOTHELIOMA. LITERATURE REVIEW AND ANALYSIS OF OWN OBSERVATIONS

Abstract

Pleural mesothelioma (MP) remains an aggressive disease with a poor prognosis and a median survival of no more than 18-20 months, despite the use of all current treatment approaches. Radiation therapy for MP is traditionally used as a part of a three-modal approach in radical treatment. The lack of reliable randomized trials has led to an absence of consensus of the optimal radical treatment strategy and current guidelines for the MP treatment are quite contradictory regarding the use of radiotherapy. A literature based on the MedLine database, Web of Science was analyzed. Our own experience in multimodal treatment of 8 patients with MP based on retrospective data demonstrates low local control in the irradiated area: 4 patients had isolated local relapse during 1 year; 4 patients had local relapse in combination with distant progression. Univariate analysis had not revealed predictors of isolated local progression after adjuvant radiation therapy in multimodal treatment. Although the role of radiotherapy in the treatment of MP remains unclear, significant successes in planning and conducting of radiation therapy show, that long-term survival now can be achieved for these patients, for whom, until recently, only palliative treatment had been considered appropriate.