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

By Kaitlyn Kosko - Last Updated: February 21, 2024

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. 

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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.

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