This multicenter, open-label phase III study evaluated the utility of prophylactic radiation to prevent procedure-tract metastases in 203 patients with malignant pleural mesothelioma. No significant differences were observed in procedure-tract metastases incidence in those who received immediate radiotherapy vs those receiving deferred radiation therapy.
Routine universal prophylactic radiotherapy to prevent procedure-tract metastases in patients with malignant pleural mesothelioma offers no clear clinical benefit.
The use of prophylactic radiotherapy to prevent procedure-tract metastases (PTMs) in malignant pleural mesothelioma remains controversial, and clinical practice varies worldwide. We aimed to compare prophylactic radiotherapy with deferred radiotherapy (given only when a PTM developed) in a suitably powered trial.
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