A pilot trial of high-dose-rate intraoperative radiation therapy for malignant pleural mesothelioma

Kenneth E. Rosenzweig, Jana L. Fox, Michael J. Zelefsky, Adam Raben, Louis B. Harrison, Valerie W. Rusch

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

PURPOSE: To report results of a phase II trial of high-dose-rate intra-operative radiation therapy (HDR-IORT) for malignant pleural mesothelioma (MPM). METHODS AND MATERIALS: Seven patients had extrapleural pneumonectomy with IORT (EPP/IORT) and 6 patients had pleurectomy/decortication with IORT (PD/IORT) between 1994 and 1996. IORT was delivered with 192Ir using a customized applicator with a remote afterloader. A median of 3 sites were treated to a median area of 143 cm 2. A dose of 1500 cGy was prescribed at each site, with 1000 cGy delivered to the mediastinum. Postoperative external beam radiation therapy (EBRT) was given 3-5 weeks later. Median follow-up was 8 months (range, 1-84 months). RESULTS: Five patients developed local failure. Two-year local control and survival rates were 35% and 23%, respectively. Mortality was 2/13 (15%), 1 from each surgical group. Serious complications requiring further intervention occurred in 3/6 (50%) of the EPP/IORT group and 1/5 (20%) of the PD/IORT group. CONCLUSIONS: HDR-IORT after EPP for MPM is prohibitively toxic and has been abandoned, while its use with PD remains in question.

Original languageEnglish (US)
Pages (from-to)30-33
Number of pages4
JournalBrachytherapy
Volume4
Issue number1
DOIs
StatePublished - 2005
Externally publishedYes

Fingerprint

Radiotherapy
Pneumonectomy
Poisons
Mediastinum
Survival Rate
Mortality
Malignant Mesothelioma

Keywords

  • Brachytherapy
  • Decortication
  • Extrapleural pneumonectomy
  • HAM applicator
  • HDR-IORT
  • Mesothelioma
  • Pleurectomy
  • Radiation therapy
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

A pilot trial of high-dose-rate intraoperative radiation therapy for malignant pleural mesothelioma. / Rosenzweig, Kenneth E.; Fox, Jana L.; Zelefsky, Michael J.; Raben, Adam; Harrison, Louis B.; Rusch, Valerie W.

In: Brachytherapy, Vol. 4, No. 1, 2005, p. 30-33.

Research output: Contribution to journalArticle

Rosenzweig, Kenneth E. ; Fox, Jana L. ; Zelefsky, Michael J. ; Raben, Adam ; Harrison, Louis B. ; Rusch, Valerie W. / A pilot trial of high-dose-rate intraoperative radiation therapy for malignant pleural mesothelioma. In: Brachytherapy. 2005 ; Vol. 4, No. 1. pp. 30-33.
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N2 - PURPOSE: To report results of a phase II trial of high-dose-rate intra-operative radiation therapy (HDR-IORT) for malignant pleural mesothelioma (MPM). METHODS AND MATERIALS: Seven patients had extrapleural pneumonectomy with IORT (EPP/IORT) and 6 patients had pleurectomy/decortication with IORT (PD/IORT) between 1994 and 1996. IORT was delivered with 192Ir using a customized applicator with a remote afterloader. A median of 3 sites were treated to a median area of 143 cm 2. A dose of 1500 cGy was prescribed at each site, with 1000 cGy delivered to the mediastinum. Postoperative external beam radiation therapy (EBRT) was given 3-5 weeks later. Median follow-up was 8 months (range, 1-84 months). RESULTS: Five patients developed local failure. Two-year local control and survival rates were 35% and 23%, respectively. Mortality was 2/13 (15%), 1 from each surgical group. Serious complications requiring further intervention occurred in 3/6 (50%) of the EPP/IORT group and 1/5 (20%) of the PD/IORT group. CONCLUSIONS: HDR-IORT after EPP for MPM is prohibitively toxic and has been abandoned, while its use with PD remains in question.

AB - PURPOSE: To report results of a phase II trial of high-dose-rate intra-operative radiation therapy (HDR-IORT) for malignant pleural mesothelioma (MPM). METHODS AND MATERIALS: Seven patients had extrapleural pneumonectomy with IORT (EPP/IORT) and 6 patients had pleurectomy/decortication with IORT (PD/IORT) between 1994 and 1996. IORT was delivered with 192Ir using a customized applicator with a remote afterloader. A median of 3 sites were treated to a median area of 143 cm 2. A dose of 1500 cGy was prescribed at each site, with 1000 cGy delivered to the mediastinum. Postoperative external beam radiation therapy (EBRT) was given 3-5 weeks later. Median follow-up was 8 months (range, 1-84 months). RESULTS: Five patients developed local failure. Two-year local control and survival rates were 35% and 23%, respectively. Mortality was 2/13 (15%), 1 from each surgical group. Serious complications requiring further intervention occurred in 3/6 (50%) of the EPP/IORT group and 1/5 (20%) of the PD/IORT group. CONCLUSIONS: HDR-IORT after EPP for MPM is prohibitively toxic and has been abandoned, while its use with PD remains in question.

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