Combined Modality Treatment in Mesothelioma

A Systemic Literature Review With Treatment Recommendations

Charlotte De Bondt; Ioannis Psallidas; Paul E. Y. Van Schil; Jan P. van Meerbeeck


Transl Lung Cancer Res. 2018;7(5) 

In This Article


  1. There is level 2 evidence that a multimodality treatment consisting of at least macroscopic resection and CT, is superior to either single modality in selected patients with regard to survival, but at the cost of increased treatment related morbidity and mortality. Selected patients should be adequately informed and referred to expert centers in order to be included in either clinical trials or large institutional series (grade of recommendation: D).

  2. There is level 2+ evidence that for PORT, IMRT techniques should be preferred over conventional 3D RT (grade of recommendation: C).

  3. There is level 3 evidence that a carboplatin-based platinum-pemetrexed doublet is non-inferior to a cisplatin based one as a (neo-)adjuvant CT regimen with less toxicity (grade of recommendation: D).

  4. There is level 2 evidence for neo-adjuvant CT to be preferred over adjuvant CT in a multimodality approach (grade of recommendation: D).

  5. No recommendation can be made regarding the optimal sequencing of RT in a combined modality treatment protocol.