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Is radiation therapy effective for pain control for patients with mesothelioma?

Radiation therapy has very clear indications for symptom management for two problems with mesothelioma:  1) pain control and 2) preventing drain/incison failures.  Several retrospective studies demonstrate improvement in mesothelioma-induced pain, with doses above 45Gy showing the best efficacy.  We typically treat patients to 45Gy in 15 fractions over 3 weeks.  In my experience, the great majority of patients treated for pain get at least transient improvement with this regimen.  Radiation has also been shown to essentially eliminate drain/incision failures.  Twenty to forty percent of patients will experience a failure at a drain site or incision site.  These are often very painful.  Three treatments of 7 Gy can essentially eliminate such failure if done soon after the drains are removed, or the incision closed.

--Craig Stevens, MD, PhD, H. Lee Moffitt Cancer Center & Research Institute


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