Non-ablative hypofractionated hemithoracic radiation—a new standard of care in mesothelioma?
The role of radiation therapy in malignant pleural mesothelioma (MPM) has been explored for the past 50 years. Originally, MPMs were thought radioresistant tumors. However, experimental evidence suggested otherwise (1). For instance, in vitro studies have shown that mesothelioma cell lines were more sensitive to radiation than non-small cell lung cancer cell lines, experiments in mice models of mesothelioma have shown response to radiation therapy, clinical studies have demonstrated benefit of radiation in the palliative setting when specific areas of the chest were targeted, and hemithoracic radiation have shown good local control when combined with radical surgery [see review in (1) for specific references].