NCCN Guidelines for Patients
Malignant Pleural Mesothelioma, Version 1.2016
Your treatment team will decide the best time to
have radiation therapy after surgery. During radiation
treatment, you will lie on a table in the same position
as done during simulation. Devices may be used to
keep you from moving so that the radiation targets
the tumor. Likewise, methods may be applied to
You will be alone while the technician operates the
radiation machine from a nearby room. He or she will
be able to see, hear, and speak with you at all times.
As treatment is being given, you may hear noises.
One treatment session can take between 30 to 60
minutes. You will likely have 5 sessions a week.
Radiation therapy lasts 4 to 5 weeks if no cancer
cells are found in the normal-looking tissue around
the tumor removed during surgery. If cancer is found
in the normal-looking tissue, radiation therapy lasts
about 5 to 6 weeks.
The main types of EBRT used for mesothelioma
herapy) – Radiation is given in small doses for
a few weeks with x-ray beams that match the
shape of the tumor.
– Radiation is given in small doses for a few
weeks with x-ray beams of different strengths
based on the thickness of the tumor.
Tomotherapy – A type of IMRT, a tomotherapy
machine takes CT scans and delivers radiation.
Proton beam therapy – Radiation is given using
proton beams, which deliver more radiation at
the end rather than throughout the beam.
Conformal radiation therapy is the preferred method
by NCCN doctors. IMRT, tomotherapy, and proton
beam therapy are newer radiation therapy methods.
They should only be used in experienced cancer
centers or according to a specific, detailed treatment
plan called a protocol.
Stage I–III epithelioid or mixed mesothelioma