Controversies in the role of radiotherapy in pleural mesothelioma

摘要: Malignant pleural mesothelioma is an uncommon thoracic cancer with a relatively poor outcome, which has only seen modest improvements when compared to non-small cell lung cancer. The mainstays of treatment have been surgery and systemic therapy, radiation reserved for palliation or as adjunct. However, there re-emergent interest in the use radiotherapy mesothelioma, given recent technical advances delivery permit increased accuracy. This overview article reviews radiobiology whether not inherently radioresistant potential impact that hypofractionation may on different histological subtypes mesothelioma. also considers role palliation, adjunct surgical resection tract procedures. In particular we review growing evidence port site adjuvant provides no clinical benefit. will consider emerging therapeutic strategies such pre-operative short course hypofractionated radiotherapy. novel techniques stereotactic ablative radiotherapy, image guided proton therapy immune stimulating agent combination immunotherapy, be discussed. Finally, many unanswered questions, this discusses some ongoing trials