Radiation Therapy for Mesothelioma - Revision history

MesotheliomaSupport: Fix structural reference errors: remove orphaned/duplicate refs (RON-2026-04-05-003)

2026-04-06T09:57:15Z

Fix structural reference errors: remove orphaned/duplicate refs (RON-2026-04-05-003)

← Older revision		Revision as of 09:57, 6 April 2026
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	<ref name="pit-manchester">[https://research.manchester.ac.uk/en/impacts/confirmation-that-prophylactic-irradiation-of-tracts-pit-is-not-j Confirmation that prophylactic irradiation of tracts (PIT) is not justified in routine mesothelioma treatment], University of Manchester Research</ref>		<ref name="pit-manchester">[https://research.manchester.ac.uk/en/impacts/confirmation-that-prophylactic-irradiation-of-tracts-pit-is-not-j Confirmation that prophylactic irradiation of tracts (PIT) is not justified in routine mesothelioma treatment], University of Manchester Research</ref>
	<ref name="ptcog-consensus">[https://pubmed.ncbi.nlm.nih.gov/32461036/ Consensus Statement on Proton Therapy in Mesothelioma], PubMed (PMID: 32461036)</ref>		<ref name="ptcog-consensus">[https://pubmed.ncbi.nlm.nih.gov/32461036/ Consensus Statement on Proton Therapy in Mesothelioma], PubMed (PMID: 32461036)</ref>
	~~<ref name="nrg-update">[https://www.gtsc.org/files/Meetings/2021%20Ginsberg%20Day/Donington_NRG_update_2021_GTSC_PPT_Template.pdf NRG Trial Update 2021], General Thoracic Surgical Club</ref>~~
	<ref name="nyu-radiation">[https://nyulangone.org/conditions/malignant-mesothelioma/treatments/radiation-therapy-for-malignant-mesothelioma Radiation Therapy for Malignant Mesothelioma], NYU Langone Health</ref>		<ref name="nyu-radiation">[https://nyulangone.org/conditions/malignant-mesothelioma/treatments/radiation-therapy-for-malignant-mesothelioma Radiation Therapy for Malignant Mesothelioma], NYU Langone Health</ref>
	<ref name="nrg-lu006">[https://www.nrgoncology.org/Clinical-Trials/Protocol/nrg-lu006/ NRG-LU006: Phase III Trial of P/D Plus Systemic Therapy With or Without Adjuvant Radiation], NRG Oncology</ref>		<ref name="nrg-lu006">[https://www.nrgoncology.org/Clinical-Trials/Protocol/nrg-lu006/ NRG-LU006: Phase III Trial of P/D Plus Systemic Therapy With or Without Adjuvant Radiation], NRG Oncology</ref>

MesotheliomaSupport: Add differentiated triple GEO format

2026-03-08T22:11:19Z

Add differentiated triple GEO format

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MesotheliomaSupport: Remove redundant H1, add bold key phrases to lead, add at-a-glance listicle to fill blank space beside infobox

2026-02-24T05:21:41Z

Remove redundant H1, add bold key phrases to lead, add at-a-glance listicle to fill blank space beside infobox

← Older revision		Revision as of 05:21, 24 February 2026
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	= Radiation ~~Therapy~~ for ~~Mesothelioma~~: ~~Techniques~~, ~~Protocols~~, and ~~Outcomes~~ =		'''Radiation therapy''' for [[Pleural_Mesothelioma\|malignant pleural mesothelioma]] has evolved from a purely palliative tool into a component of '''multimodality curative-intent treatment strategies'''. Despite historical perceptions of radioresistance, laboratory studies demonstrate that mesothelioma cell lines exhibit sensitivity comparable to or better than non-small cell lung cancer.<ref name="proton-pmc" /><ref name="controversies" /> The principal challenge is not tumor biology but anatomy: the pleural surface is a large, complex target that encases radiosensitive organs including the lungs, heart, esophagus, liver, and kidneys. Advances in '''intensity-modulated radiation therapy (IMRT)''', pencil-beam scanning proton therapy, and novel sequencing strategies such as the '''SMART protocol''' have expanded the therapeutic window.<ref name="annalscts" /><ref name="dandell-radiation" /> This page covers all clinical applications of radiation in mesothelioma, including adjuvant therapy after surgery, the SMART protocol, IMRT and proton techniques, palliative radiation, prophylactic tract irradiation, side effect management, and ongoing clinical trials as of 2026.

	~~Radiation~~ therapy for ~~[[Pleural_Mesothelioma\|malignant pleural~~ mesothelioma~~]] has evolved from a purely palliative tool into a component of multimodality curative-intent treatment strategies. Despite historical perceptions of radioresistance, laboratory~~ studies ~~demonstrate that~~ mesothelioma ~~cell lines exhibit~~ sensitivity comparable to ~~or better than non-small cell lung cancer.~~<ref name="proton-pmc" /><ref name="~~controversies~~" /> The principal challenge is not tumor biology but anatomy: the pleural surface is a large, complex target that encases radiosensitive organs including the lungs, heart, esophagus, liver, and kidneys. Advances in intensity-modulated ~~radiation~~ therapy (IMRT)~~, pencil~~-~~beam scanning proton therapy, and novel sequencing strategies such as the SMART protocol have expanded the therapeutic window.~~<ref name="~~annalscts~~" /><ref name="~~dandell~~-radiation" /> ~~This page covers all~~ clinical ~~applications of radiation in mesothelioma~~, ~~including adjuvant therapy after surgery~~, ~~the SMART protocol, IMRT~~ and ~~proton techniques, palliative radiation, prophylactic tract irradiation, side effect management,~~ and ~~ongoing clinical trials as of 2026.~~		'''Key radiation therapy insights for mesothelioma:'''
			* '''Not truly radioresistant''' — lab studies show mesothelioma sensitivity comparable to NSCLC<ref name="proton-pmc" />
			* '''SMART protocol breakthrough''' — 65.9-month median survival in epithelioid, node-negative patients<ref name="smart-lancet" />
			* '''IMRT precision''' — intensity-modulated technique enables hemithoracic treatment with organ-sparing<ref name="annalscts" />
			* '''Proton therapy advantage''' — reduces heart dose from 25 Gy (IMRT) to just 6 Gy<ref name="proton-pmc" />
			* '''60–80% palliative relief''' — most patients report meaningful symptom improvement<ref name="mesonet-radiation" />
			* '''Tract irradiation abandoned''' — no longer recommended after 4 negative randomized trials including 374-patient PIT study<ref name="controversies" />
			* '''Critical dose limit''' — combined mean lung dose must stay below 20 Gy to prevent fatal pneumonitis<ref name="controversies" />
			* '''Peritoneal role minimal''' — CRS-HIPEC preferred; radiation plays limited role in [[Peritoneal_Mesothelioma\|peritoneal disease]]<ref name="nyu-radiation" />
			* '''Active clinical trials''' — SMARTER, SYSTEMS-2, and MESO-PRIME testing dose escalation and immunotherapy combinations<ref name="controversies" />

	== Key Facts ==		== Key Facts ==

MesotheliomaSupport: New page: Comprehensive radiation therapy guide covering SMART protocol, IMRT, proton therapy, adjuvant/palliative approaches, prophylactic tract irradiation evidence, side effects, and clinical trials — 29 references, 7 FAQs, 10 categories

2026-02-24T04:32:11Z

New page: Comprehensive radiation therapy guide covering SMART protocol, IMRT, proton therapy, adjuvant/palliative approaches, prophylactic tract irradiation evidence, side effects, and clinical trials — 29 references, 7 FAQs, 10 categories

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