Lung-sparing intensity-modulated radiotherapy in malignant pleural mesothelioma: palliative or potentially radical?

Malignant pleural mesothelioma (MPM) is a rare and aggressive tumour and its prognosis is dismal. The ASCO and the ESMO guidelines both place a platinum-pemetrexed (or raltitrexed)-based chemotherapy for 4 to 6 cycles as standard of care in fit patients (1,2). However, the median overall survival (OS) is only approximately 12 months, with hardly any 5-year survivors (2).