Prophylactic Radiotherapy For Procedure Tract Metastases In Malignant Pleural Mesothelioma:A Meta-analysis

Objective:To systematically evaluate if prophylactic radiotherapy could reduce the incidence of procedure track metastases(PTMs)in patients with malignant pleural mesothelioma(MPM).Methods:Databases including PubMed,Cochrane Library,Web of Science,EMBase were searched to collect studies about prophylactic radiotherapy for procedure tracks in MPM.Two reviewers independently screened literature,extracted data,and evaluated the methodological quality of included studies.Then,meta-analysis was performed using RevMan 5.3 software.Results:A total of seven studies involving 698 patients were included.Meta-analysis results showed that prophylactic radiotherapy could not reduce the incidence of PTMs in all MPM patients(OR=0.48,95%CI:0.22-1.07,P=0.07),but prophylactic radiotherapy could prevent PTMs in the subgroups of large bore procedures(OR=0.39,95%CI:0.18-0.84,P=0.02)and histologic type of epithelial MPM(OR=0.21,95%CI:0.11-0.69,P=0.006).Conclusion:The current evidence shows that prophylactic radiotherapy could prevent PTMs in MPM patients undergone large bore procedures(like thoracotomy,thoracoscopy,indwelling pleural catheter insertion)and in patients with histologic type of epithelial MPM.Due to the limited quality and quantity of the included studies,more studies are needed to verify the above conclusion.