Pattern of failure after adjuvant radiotherapy following extrapleural pneumonectomy of pleural mesothelioma in the SAKK 17/04 trial

Oliver Riesterer; I Frank Ciernik; Rolf A Stahel; Alexandros Xyrafas; Daniel M Aebersold; Ludwig Plasswilm; E Mahmut Ozsahin; Daniel R Zwahlen; Kristiaan Nackaerts; Frank Zimmermann; L Sabrina Stark; Walter Weder; Jérôme Krayenbuehl; Swiss Group for Clinical Cancer Research (SAKK)

doi:10.1016/j.radonc.2019.05.024

Pattern of failure after adjuvant radiotherapy following extrapleural pneumonectomy of pleural mesothelioma in the SAKK 17/04 trial

Radiother Oncol. 2019 Sep:138:121-125. doi: 10.1016/j.radonc.2019.05.024. Epub 2019 Jun 25.

Affiliations

¹ Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland; Center for Radiation Oncology KSA-KSB, Kantonsspital Aarau, Switzerland. Electronic address: oliver.riesterer@ksa.ch.
² Department of Radiotherapy and Radiation Oncology, Dessau, Germany.
³ Cancer Center Zurich, University Hospital Zurich, University of Zurich, Switzerland.
⁴ Swiss Group for Clinical Cancer Research (SAKK) Coordinating Center, Bern, Switzerland.
⁵ Department of Radiation Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland.
⁶ Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, University of Bern, Switzerland.
⁷ Department of Radiation Oncology, University Hospital Lausanne - CHUV, Lausanne, Switzerland.
⁸ Department of Radiation Oncology, Kantonsspital Graubünden, Chur, Switzerland.
⁹ Department of Pneumology, KU Leuven, University Hospitals Leuven, Leuven, Belgium.
¹⁰ Department of Radiation Oncology, University Hospital Basel, Basel, Switzerland.
¹¹ Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland.
¹² Thoracic Surgery Center, University Hospital Zurich, University of Zurich, Switzerland.

PMID: 31252293
DOI: 10.1016/j.radonc.2019.05.024

Abstract

Postoperative radiotherapy after extrapleural pneumonectomy of malignant pleural mesothelioma was investigated in the randomized phase II trial SAKK17/04. The relapse rate within the high and/or low-dose PTV without previous distant failure was 24%, the isolated in-field-relapse rate within the PTVs was 5% and the distant relapse rate outside of the PTVs was 81%. Clinical outcome was mainly determined by distant disease progression outside of the radiation field.

Keywords: Extrapleural pneumonectomy; Mesothelioma; Multimodal therapy; Radiation therapy; Radiotherapy; Trimodal therapy.

Publication types

Clinical Trial, Phase II
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Dose-Response Relationship, Radiation
Female
Follow-Up Studies
Humans
Lung Neoplasms / pathology
Lung Neoplasms / radiotherapy*
Lung Neoplasms / surgery*
Male
Mesothelioma / pathology
Mesothelioma / radiotherapy*
Mesothelioma / surgery*
Mesothelioma, Malignant
Middle Aged
Neoplasm Recurrence, Local / diagnosis*
Neoplasm Recurrence, Local / pathology
Pleural Neoplasms / pathology
Pleural Neoplasms / radiotherapy*
Pleural Neoplasms / surgery*
Pneumonectomy
Radiotherapy, Adjuvant
Treatment Outcome