The role of radiation therapy in malignant pleural mesothelioma is
controversial. It has been used as part of multimodal definitive treatment to ameliorate
locoregional control after removal of early disease, as prophylaxis to decrease the
probability of recurrence and pain at sites of diagnostic or therapeutic instrument
insertion and as symptom palliation in patients with advanced disease. Intensity
modulated radiotherapy in the adjuvant mode after extrapleural pneumonectomy
achieves good local control with acceptable toxicity. Increasing interest can be seen
with radical pleural intensity modulated radiotherapy with intact lung. Prophylactic
irradiation can be performed for patients who are in good performance status with a
longer life expectancy. So far, pain control seems to be the best evidenced application
of radiation therapy.
Keywords: Extrapleural pneumonectomy, pleurectomy/decortication, radiotherapy,
trimodality therapy.
