Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Oncology Radiation

This is prospective study-reviewing patients with pleural mesothelioma who are unable to undergo surgery. We have implemented a technique using intensity-modulated radiotherapy (IMRT) to treat these patients. This work aimed to study the toxicity and effect of radiotherapy on progression-free survival and overall survival. {uF076} Patients and methods: Between 2016 and 2020, 50 patients with unresectable malignant pleural mesothelioma following chemotherapy, of both sex and different age groups, were treated with pleural IMRT to the hemithorax (median dose, 46.8 Gy) with or without concurrent chemotherapy at The National Cancer Institute, Cairo University. {uF076} Results: Of the 50 patients, 38% had stage II, 62 % had stage III, and all received induction chemotherapy (mostly cisplatin and pemetrexed) before IMRT. Of the 50 patients, thirty-nine patients (78%) were able to complete the radiotherapy protocol. Twenty-seven patients (69.2%) experienced Grade II pneumonitis while twelve patients of the thirty-nine patients (30.8%) experienced grade-III or higher pneumonitis. The median survival for all the patients in the study was 20.5 months. The 1-year and 2-years OS were 84.7 % and 31.4 %, respectively, with no significant difference in overall survival between the two arms. Patients who received two lines of chemotherapy had statistically significant better overall survival than patients who received one line of chemotherapy with a median survival of 32 months compared to 16.2 months respectively.(P=0.001)

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