The role of radiation therapy in the treatment of patients with pleural mesothelioma

Pleural mesothelioma (PM) remains a disease with a poor prognosis, despite the use of the newest achievements of multimodal treatment. Radiation therapy for PM is traditionally used in some directions: in radical treatment as a part of a three-modal approach, for reducing the risk of chest metastasis in areas of invasive interventions and during palliative treatment. The lack of reliable randomized trials has led to an absence of consensus about the optimal radical treatment strategy. Mordern global recommendations for the treatment of PM are controversial regarding the use of adjuvant radiotherapy in multimodal treatment. Although the role of radiation therapy in the treatment of PM remains unclear, significant successes in planning and conducting radiotherapy are showing that long-term survival can be achieved for these patients, for whom, until recently, only palliative treatment was considered as appropriate treatment. For many years, preventive irradiation of areas of invasive interventions has been used as a method to prevent implantation metastasis. However, a number of randomized trials and recent meta-analysis have not demonstrated the benefits of this treatment approach. Due to the rarity of PM, the severe state of patients and tumor localization, the importance of radiation therapy in the palliative treatment of patients with pleural mesothelioma remains controversial. Recent completed and planned studies allow to commend the role of palliative radiation and recommend it in order to reduce pain.