PMID- 31616640
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200930
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 9
DP  - 2019
TI  - Stereotactic Body Radiation Therapy (SBRT) as Salvage Therapy for Oligorecurrent 
      Pleural Mesothelioma After Multi-Modality Therapy.
PG  - 961
LID - 10.3389/fonc.2019.00961 [doi]
LID - 961
AB  - Introduction: Therapy options for patients with oligoprogressive malignant 
      pleural mesothelioma (MPM) are limited. Stereotactic Body Radiotherapy (SBRT) may 
      be a promising therapeutic option, as it delivers a localized ablative dose of 
      radiation and therefore balances efficacy and treatment related toxicities. The 
      intent of this retrospective analysis was to evaluate the feasibility of SBRT for 
      limited pleural recurrences. Methods and Materials: This retrospective 
      single-institution study is based on the 21 consecutive patients treated with 
      hypofractionated radiotherapy for oligoprogressive MPM. Clinical and radiological 
      data was collected at regular follow-up visits including toxicity, local control 
      and survival. Results: At primary diagnosis, 57% of the patients presented with 
      stage III disease. Initial treatment of MPM consisted of induction chemotherapy 
      (n = 12) prior to a macroscopic complete resection (n = 18). Three patients 
      received additional intracavitary chemotherapy and another three patients were 
      treated with chemotherapy alone without another treatment at the time of first 
      diagnosis. A total of 50 lesions in recurrent MPM were treated with SBRT. The 
      median number of radiotherapy fractions was 5 (range 3-20) with a median dose per 
      fraction of 5 Gy (range 2.5-12.5 Gy). The median total treatment dose was 30 Gy 
      (20-50 Gy) with a median prescription isodose line (IDL) of 65% (65-100%). Median 
      follow-up of all patients from diagnosis was 28 months (range 7-152 months). 
      Analyzing all lesions separately, the 12-months-local control from SBRT was 
      73.5%. The median progression free survival (PFS) after SBRT was 6 months (range 
      0-21 months) and the median OS from first first SBRT was 29 months (range 0-61 
      months). Only one patients experienced above Grade 3 toxicities. Conclusion: This 
      analysis demonstrates the feasibility of a SBRT approach for oligorecurrent MPM. 
      SBRT was well-tolerated even after multiple repetitions and local control was 
      high with a promising median OS.
CI  - Copyright (c) 2019 Schroder, Opitz, Guckenberger, Stahel, Weder, Forster, 
      Andratschke and Lauk.
FAU - Schroder, Christina
AU  - Schroder C
AD  - Department of Radiation Oncology, University Hospital Zurich, Zurich, 
      Switzerland.
FAU - Opitz, Isabelle
AU  - Opitz I
AD  - Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
FAU - Guckenberger, Matthias
AU  - Guckenberger M
AD  - Department of Radiation Oncology, University Hospital Zurich, Zurich, 
      Switzerland.
FAU - Stahel, Rolf
AU  - Stahel R
AD  - Department of Medical Oncology, University Hospital Zurich, Zurich, Switzerland.
FAU - Weder, Walter
AU  - Weder W
AD  - Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
FAU - Forster, Robert
AU  - Forster R
AD  - Department of Radiation Oncology, University Hospital Zurich, Zurich, 
      Switzerland.
FAU - Andratschke, Nicolaus
AU  - Andratschke N
AD  - Department of Radiation Oncology, University Hospital Zurich, Zurich, 
      Switzerland.
FAU - Lauk, Olivia
AU  - Lauk O
AD  - Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20190926
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC6775182
OTO - NOTNLM
OT  - SBRT
OT  - local recurrence
OT  - malignant pleural mesothelioma
OT  - oligoprogression
OT  - retrospective analysis
EDAT- 2019/10/17 06:00
MHDA- 2019/10/17 06:01
PMCR- 2019/01/01
CRDT- 2019/10/17 06:00
PHST- 2019/04/04 00:00 [received]
PHST- 2019/09/10 00:00 [accepted]
PHST- 2019/10/17 06:00 [entrez]
PHST- 2019/10/17 06:00 [pubmed]
PHST- 2019/10/17 06:01 [medline]
PHST- 2019/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2019.00961 [doi]
PST - epublish
SO  - Front Oncol. 2019 Sep 26;9:961. doi: 10.3389/fonc.2019.00961. eCollection 2019.