Survival, Safety Data for Radiation Therapy With Helical Tomotherapy in MPM

Radiation therapy with helical tomotherapy (HT) is safe and provides a survival advantage in patients with malignant pleural mesothelioma (MPM) who underwent lung-sparing surgery. Furthermore, superior survival was seen in patients who also received adjuvant chemotherapy, according to lead author Julian P. Layer, MD. 

The study’s primary end points included local control, distant control, progression-free survival (PFS), and overall survival (OS) in patients with MPM receiving intensity-modulated HT.

Thirty-four patients, who were a median age of 65 years and mostly men (77.4%), were included in the evaluation. Prior to radiation therapy, 21 (67.7%) patients underwent total or partial surgical pleurectomy. Eighteen (58.1%) patients received neoadjuvant platinum-based chemotherapy, 13 (41.9%) received adjuvant platinum-based chemotherapy, and two (6.5%) received no prior perioperative systemic therapy.

At a median follow-up of 20 months, local control and distant control were a median of 23 months. In addition, a median PFS rate of 19 months was observed in patients with a 1-year PFS rate of 72.4% and a 2-year PFS rate of 24.1%.

The median OS was 20 months. OS was 86.2% at 1 year and 41.4% at 2 years. Clinical outcome can be significantly improved by using adjuvant chemotherapy (P=.008).

Overall, intensity-modulated HT was well tolerated among patients with MPM. The most common adverse events (AEs) of all grades were fatigue (60.0%), dysphagia (50.1%), and nausea (40.0%).

Dysphagia (16.7%), dyspnea (6.7%), and pain (3.3%) were among the grade 3 AEs seen in 26.7% of patients.