Purpose

Radiation therapy for mesothelioma remains challenging, as normal tissue toxicity limits the amount of radiation that can be safely delivered to the pleural surfaces, especially radiation dose to the contralateral lung. The physical properties of proton therapy result in better sparing of normal tissues when treating the pleura, both in the postpneumonectomy setting and the lung-intact setting. Compared with photon radiation, there are dramatic reductions in dose to the contralateral lung, heart, liver, kidneys, and stomach. However, the tissue heterogeneity in the thorax, organ motion, and potential for changing anatomy during the treatment course all present challenges to optimal irradiation with protons.

Methods

The clinical data underlying proton therapy in mesothelioma are reviewed here, including indications, advantages, and limitations.

Results

The Particle Therapy Cooperative Group Thoracic Subcommittee task group provides specific guidelines for the use of proton therapy for mesothelioma.

Conclusions

This consensus report can be used to guide clinical practice, insurance approval, and future research.

中文翻译：

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间皮瘤质子治疗共识声明

目的

间皮瘤的放射治疗仍然具有挑战性，因为正常组织毒性限制了可以安全递送到胸膜表面的辐射量，尤其是对侧肺的辐射剂量。质子治疗的物理特性导致在治疗胸膜时更好地保留正常组织，无论是在肺切除术后环境中还是在肺完整环境中。与光子辐射相比，对侧肺、心脏、肝脏、肾脏和胃的剂量显着减少。然而，胸部组织的异质性、器官运动和治疗过程中解剖结构的变化都对质子的最佳照射提出了挑战。

方法

本文将总结间皮瘤质子治疗的临床数据，包括适应症、优点和局限性。

结果

粒子治疗合作小组胸科小组委员会工作组提供了使用质子治疗间皮瘤的具体指南。

结论

该共识报告可用于指导临床实践、保险审批和未来研究。