Primary Outcome Measures
- Dose limiting toxicities (DLT) [ Time Frame: up to 12 weeks ] [ Designated as safety issue: Yes]
The NCI Common Terminology Criteria for Adverse Events version 4.0 will be used to grade toxicities during the trial. DLTs are defined as any of the following events occurring during and for the first 12 weeks after completing pleural IMRT
Eligibility
- Inclusion Criteria
- Pathologically confirmed diagnosis of malignant pleural mesothelioma at MSKCC
- No plans for surgical resection
- Stage T1-4, N0-3, M0
- No prior radiation therapy to the chest, breast or supraclavicular fossa that would limit radiation delivery to the full prescription dose
- Prior chemotherapy regimens ≤1
- Age ≥18 years
- Karnofsky performance status ≥ 80%
- Pulmonary function tests as follows: DLCO>50% predicted
- Adequate hematologic, hepatic, and renal function as indicated by the following laboratory values
- Absolute neutrophil count ≥ 1,500/mcL
- Platelets ≥ 100,000/mcL
- Calculated creatinine clearance (CrCl) ≥ 45mL/min (using Cockcroft & Gault method)
- Serum total bilirubin ≤ 1.5 x upper limit of normal (ULN) (unless known Gilbert’s disease)
- AST (SGOT) and ALT (SGPT) ≤ 3.0 x ULN
- Exclusion Criteria
- Pregnant or lactating women, or men or women not using effective contraception
- Patients with an active infection that requires systemic antibiotics, antiviral, or antifungal treatments
- Patients with a concurrent active malignancy (with the exception of skin cancer)
- Patients with serious unstable medical illness
- Patients with idiopathic pulmonary fibrosis
- Patients with NYHA heart failure class >2
- Patients with only one kidney that is ipsilateral to the mesothelioma
- Implanted pacemaker and/or defibrillator ipsilateral to the mesothelioma if it cannot be moved
- Patients meeting the following exclusion criteria will be excluded from the MRI portion only
- Metallic implant, e.g. pacemaker, defibrillator
- Unmanageable claustrophobia
- High risk for nephrogenic systemic fibrosis
