- In patients with localized malignant pleural mesothelioma (MPM), adding radiotherapy to surgery+chemotherapy is associated with significantly better OS compared with surgery+chemotherapy alone.
Why this matters
- MPM is highly aggressive, and research into the most effective treatment option has yielded conflicting results.
- 1015 patients diagnosed with MPM between 1976 and 2016 from the Surveillance, Epidemiology, and End Results database.
- Funding: None.
- 66.8% received surgery+chemotherapy and 33.2% received surgery, chemotherapy, and radiotherapy.
- Trimodal therapy was associated with improved OS (HR, 0.83; P=.008) on univariate analysis, but after adjustment, the difference was no longer significant (HR, 0.91; P=.167).
- Among patients with localized disease, those receiving trimodal therapy had longer median OS than those who received surgery+chemotherapy (24 vs 15 months).
- After multivariable analysis, trimodal therapy was associated with significantly better OS, but only with localized disease (adjusted HR, 0.68; P=.025).
- Independent risk factors for poor OS included age ≥70 years, male sex, and nonepithelioid histology.
- Female sex, diagnosis after 2005, and left-sided disease were independently associated with better OS.
- No data on type of chemotherapy or radiation dose.