Malignant pleural mesothelioma: adjuvant therapy with radiation therapy
The treatment of malignant pleural mesothelioma (MPM) with radiation therapy (RT) has always been a technical challenge. For many years, conventional RT was delivered after extrapleural pneumonectomy with acceptable results. However, the benefit of RT has never been definitively proven. Novel radiation treatment techniques, such as intensity modulated radiation therapy (IMRT) were introduced, but the early experience with IMRT demonstrated troubling toxicity. Recent reports from institutions have demonstrated that with greater experience, IMRT, both in the setting of EPP or pleurectomy, can be delivered safely.