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Treating patients with high-dose radiotherapy after chemotherapy and surgery for malignant pleural mesothelioma does not achieve improvements in local relapse and overall survival, according to data from a prospective randomized phase II trial presented at ESMO 2014 Congress in Madrid.
"Mesothelioma remains a difficult disease to find better treatment options for, so we asked whether high-dose hemithoracic radiotherapy would decrease the rate or delay the time of local recurrence after chemotherapy and radical surgery," says lead author Prof Rolf A. Stahel, from the Clinic and Policlinic for Oncology, at the University Hospital Zurich, Switzerland, and current President of the European Society for Medical Oncology.
The multicentre trial included 153 patients with surgically-treatable malignant pleural mesothelioma, who were first treated with three chemotherapy cycles of cisplatin and pemetrexed, followed by surgical removal of affected lung tissue, with the goal of complete removal of the cancerous areas of lung.
In a second part of the study, researchers randomly assigned 54 patients to receive either radiotherapy or no further treatment, with the primary endpoint being the duration of relapse-free survival.
While there had been preliminary evidence suggesting that the addition of radiotherapy might improve outcomes, the study failed to find any differences in relapse-free survival between patients treated with the additional radiotherapy, and those who were not.