Prophylactic radiotherapy to intervention sites in mesothelioma: a systematic review and survey of UK practice.
Affiliation
Department of Clinical Oncology, Christie Hospital NHS Trust, Wilmslow Road, Manchester M20 4BX, UK.Issue Date
2009-11
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BACKGROUND AND PURPOSE: Patients with malignant pleural mesothelioma (MPM), who undergo chest instrumentation, may develop seeding at the site of intervention, leading to subcutaneous tumour. This is believed to be reduced by the common practice of prophylactic irradiation to intervention tracts (PIT). However, evidence to support PIT is currently inadequate and contentious. MATERIALS AND METHODS: We carried out a systematic search of published literature for articles relating to the incidence of chest wall intervention tract metastases and the use of PIT in mesothelioma. In addition, a survey of current practice was conducted in 54 UK oncology centres. RESULTS: Fourteen studies revealed an incidence of chest wall intervention tract metastases of 0-48% with a trend toward a higher rate of metastases for more invasive procedures. Three randomised controlled trials (RCTs), two prospective non-randomised studies and five retrospective series met the eligibility criteria to evaluate the role of PIT in MPM. Of the three RCTs, two did not support the use of PIT. None of the RCTs included patients who had received systemic chemotherapy. Of the oncology centres responding to the survey, 75% practiced PIT, and 80% would be interested in a trial to determine the efficacy of PIT. CONCLUSIONS: No consensus has been reached to support the use of PIT. However, most centres in the UK still offer PIT. There was widespread interest in a randomised controlled trial to establish PIT efficacy in the era of effective systemic chemotherapy for malignant pleural mesothelioma.Citation
Prophylactic radiotherapy to intervention sites in mesothelioma: a systematic review and survey of UK practice. 2009, 66 (2):150-6 Lung CancerJournal
Lung CancerDOI
10.1016/j.lungcan.2009.06.014PubMed ID
19628291Type
ArticleLanguage
enISSN
1872-8332ae974a485f413a2113503eed53cd6c53
10.1016/j.lungcan.2009.06.014