International Journal of Hematology and Oncology
2023, Vol 33, Num 4 Page(s): 020-026
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The Efficiency and Toxicity of Hemithoracic Radiotherapy After Extra Pleural Pneumonectomy in Malign Pleural Mesothelioma
Pervin HURMUZ1, Fadıl AKYOL1, Ugur SELEK1, Gokhan OZYIGIT1, Riza DOGAN2, Nezih OZDEMIR3, Irfan TASTEPE4, Ayten K. CANGIR3, Murat KARA2, Figen B. DEMIRKAZIK5, Salih EMRI6
1Hacettepe University Faculty of Medicine, Department of Radiation Oncology, Ankara, TURKEY
2Hacettepe University Faculty of Medicine, Department of Thoracic Surgery, Ankara, TURKEY
3Ankara University Faculty of Medicine, Department of Thoracic Surgery, Ankara, TURKEY
4Atatürk Eğitim ve Araştırma Hastanesi Section of Thoracic Surgery, Ankara, TURKEY
5Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, TURKEY
6Hacettepe University Faculty of Medicine, Department of Chest Diseases, Ankara, TURKEY
Keywords: Malign pleural mesothelioma, Extra pleural pleurectomy, Three dimensional conformal radiotherapy
In this study, we evaluated the efficiency and the toxicity of three dimensional conformal hemithoracic radiotherapy (3DCHRT) after extra pleural pneumonectomy (EPP). The median age of 14 patients were 51 years (range, 33-61 years). Most commonly seen histopathology was epitheliod type (79%). According to American Joint Commission on Cancer (AJCC) 2002 staging system 9 cases (64%) were stage III. A total median dose of 50.4 Gy was applied to hemithoracic cavity. Eleven patients received adjuvant chemotherapy. 3DCHRT was generally well tolerated. The acute toxicities of 3DCHRT were grade I-II. After a median of 16 months follow-up, intrathoracic control was100%. Six patients (43%) developed abdominal relapse and one (7%) developed distant metastasis. Nine cases were dead with two of them being without the evidence of disease. Excellent local control with 3DCHRT after EPP seems to change the relapse patterns of MPM. More effective systemic treatment is needed to prevent the recurrences outside thorax.
Pervin HURMUZ1, Fadıl AKYOL1, Ugur SELEK1, Gokhan OZYIGIT1, Riza DOGAN2, Nezih OZDEMIR3, Irfan TASTEPE4, Ayten K. CANGIR3, Murat KARA2, Figen B. DEMIRKAZIK5, Salih EMRI6
1Hacettepe University Faculty of Medicine, Department of Radiation Oncology, Ankara, TURKEY
2Hacettepe University Faculty of Medicine, Department of Thoracic Surgery, Ankara, TURKEY
3Ankara University Faculty of Medicine, Department of Thoracic Surgery, Ankara, TURKEY
4Atatürk Eğitim ve Araştırma Hastanesi Section of Thoracic Surgery, Ankara, TURKEY
5Hacettepe University Faculty of Medicine, Department of Radiology, Ankara, TURKEY
6Hacettepe University Faculty of Medicine, Department of Chest Diseases, Ankara, TURKEY
Keywords: Malign pleural mesothelioma, Extra pleural pleurectomy, Three dimensional conformal radiotherapy
In this study, we evaluated the efficiency and the toxicity of three dimensional conformal hemithoracic radiotherapy (3DCHRT) after extra pleural pneumonectomy (EPP). The median age of 14 patients were 51 years (range, 33-61 years). Most commonly seen histopathology was epitheliod type (79%). According to American Joint Commission on Cancer (AJCC) 2002 staging system 9 cases (64%) were stage III. A total median dose of 50.4 Gy was applied to hemithoracic cavity. Eleven patients received adjuvant chemotherapy. 3DCHRT was generally well tolerated. The acute toxicities of 3DCHRT were grade I-II. After a median of 16 months follow-up, intrathoracic control was100%. Six patients (43%) developed abdominal relapse and one (7%) developed distant metastasis. Nine cases were dead with two of them being without the evidence of disease. Excellent local control with 3DCHRT after EPP seems to change the relapse patterns of MPM. More effective systemic treatment is needed to prevent the recurrences outside thorax.
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