GOECP/SEOR clinical guidelines on radiotherapy for malignant pleural mesothelioma

Figure 1 Clinical target volume: Volume encompassing entire pleura and ipsilateral chest wall as well as any sites at risk of residual disease. A: Chest wall and ribs; B: Lateral border of sternum; C: Costovertebral joints and lateral edge of vertebra; D: Surgical incision area; E: Anterior pericardium.

Figure 2 Volumetric modulated arc therapy with three complete arcs. Isodose: blue (5040 cGy-100%), red (4788 cGy-95%), purple (5292 cGy-105%).

Figure 3 Patient with left malignant pleural mesothelioma treated with volumetric modulated arc therapy with palliative intent.

Figure 4 Patient with predominantly central malignant pleural mesothelioma treated with volumetric modulated arc therapy.

Figure 5 Dose distribution of radiotherapy treatment with volumetric modulated arc therapy. Note the adequate conformation to the clinical treatment volume, avoiding organs at risk.

Figure 6 Low dose distribution of radiotherapy treatment with volumetric modulated arc therapy. Note the adequate conformation to the clinical treatment volume, avoiding organs at risk, specially the heart, esophagus, and contralateral lung.