A 72-year-old female was found to have a large primary mesothelioma of the right flank musculature. She was not felt to be surgically resectable and was treated with 3D-conformal radiotherapy alone to a total dose 70 Gy. She had a complete response with no evidence of local progression when two years after treatment imaging revealed lung metastases, confirmed on biopsy. The present case suggests that radiotherapy alone can provide sustained local control of mesothelioma.
References
1.
TsiourisA.WalesbyR. K.Malignant pleural mesothelioma: Current concepts in treatment. Nat Clin Pract Oncol4, 344–352 (2007).
2.
MarkakiS.ProtopapasA.MilingosS.LazarisD.AntsaklisA.MichalasS.Primary malignant mesothelioma of the peritoneum: A clinical and immunohistochemical study. Gynecol Oncol96, 860–864 (2005).
3.
ZellosL. S.SugarbakerD. J.Diffuse malignant mesothelioma of the pleural space and its management. Oncology (Williston Park)16, 907–913 (2002).
SenkottaiyanN.SeacordL. M.FullingK. H.BirchemJ. A.FraleyM. A.AlpertM. A.Sarcomatous pleural mesothelioma metastatic to left ventricular endocardium. Angiology57, 517–521 (2006).
7.
TakedaT.NishimuraY.TsuchiyaT.NakataK.TakenakaK.NakataH.YokoyamaM.A large abdominal wall mass as an initial manifestation of malignant mesothelioma. Am J Med Sci333, 218–220 (2007).
8.
UngY. C.YuE.FalksonC.HaynesA. E.Stys-NormanD.EvansW. K.Lung Cancer Disease Site Group of Cancer Care Ontario's Program in Evidence-based Care. The role of radiation therapy in malignant pleural mesothelioma: A systematic review. Radiother Oncol80, 13–18 (2006l).
9.
HolstiL. R.PyrhönenS.KajantiM.MäntyläM.MattsonK.MaasiltaP.KivisaariL.Altered fractionation of hemithorax irradiation for pleural mesothelioma and failure patterns after treatment. Acta Oncol36, 397–405 (1997).
10.
CarmichaelJ.DegraffW. G.GamsonJ.RussoD.GazdarA. F.LevittM. L.MinnaJ. D.MitchellJ. B.Radiation sensitivity of human lung cancer cell lines. Eur J Cancer Clin Oncol25, 527–534 (1989).
11.
HäkkinenA. M.LaasonenA.LinnainmaaK.MattsonK.PyrhönenS.Radiosensitivity of mesothelioma cell lines. Acta Oncol35, 451–456 (1996).
12.
WaiteK.GilliganD.The role of radiotherapy in the treatment of malignant pleural mesothelioma. Clin Oncol (R Coll Radiol)19, 182–187 (2007).
13.
GordonW.AntmanK. H.GreenbergerJ. S.WeichselbaumR. R.ChaffeyJ. T.Radiation therapy in the management of patients with mesothelioma. Int J Radiat Oncol Biol Phys8, 19–25 (1982).
14.
AllenA. M.CzerminskaM.JänneP. A.SugarbakerD. J.BuenoR.HarrisJ. R.CourtL.BaldiniE. H.Fatal pneumonitis associated with intensity-modulated radiation therapy for mesothelioma. Int J Radiat Oncol Biol Phys65, 640–645 (2006).