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Impact of age, systemic treatment, RT dose, and recurrence patterns was analyzed by univariate and multivariate analysis. As a\u00a0secondary endpoint, reported toxicity was assessed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A\u00a0total of 34\u00a0localized MPM cases undergoing IMHT were identified, of which follow-up data were available for 31\u00a0patients. Grade\u00a03 side effects were experienced by 26.7% of patients and there were no grade\u00a04 or 5\u00a0events observed. Median PFS was 19\u00a0months. Median OS was 20\u00a0months and the rates for 1\u2011 and 2\u2011year OS were 86.2 and 41.4%, respectively. OS was significantly superior for patients receiving adjuvant chemotherapy (<jats:italic>p<\/jats:italic>\u202f=\u20090.008).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>IMHT of locally advanced MPM after lung-sparing surgery is safe and feasible, resulting in satisfactory local control and survival. Adjuvant chemotherapy significantly improves OS. Randomized clinical trials incorporating modern RT techniques as a\u00a0component of trimodal treatment are warranted to establish an evidence-based standard of care pattern for locally advanced MPM.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00066-023-02174-7","type":"journal-article","created":{"date-parts":[[2023,11,22]],"date-time":"2023-11-22T21:41:16Z","timestamp":1700689276000},"page":"605-613","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Safety and efficacy of helical tomotherapy following lung-sparing surgery in locally advanced malignant pleural mesothelioma"],"prefix":"10.1007","volume":"200","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7692-7775","authenticated-orcid":false,"given":"Julian P.","family":"Layer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascal","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cas S.","family":"Dejonckheere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo R.","family":"Sarria","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebekka","family":"Mispelbaum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tessa","family":"Hattenhauer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shari","family":"Wiegreffe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea R.","family":"Glasmacher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Layer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youness","family":"Nour","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara","family":"Caglayan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franziska","family":"Grau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"M\u00fcdder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00fcmtaz","family":"K\u00f6ksal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Scafa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank A.","family":"Giordano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Lopez-Pastorini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erich","family":"Stoelben","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonard Christopher","family":"Schmeel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Leitzen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,11,22]]},"reference":[{"key":"2174_CR1","doi-asserted-by":"publisher","first-page":"457","DOI":"10.3978\/j.issn.2225-319X.2012.10.07","volume":"1","author":"A Rimner","year":"2012","unstructured":"Rimner\u00a0A, Rosenzweig\u00a0KE (2012) Novel radiation therapy approaches in malignant pleural mesothelioma. 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F.A.\u00a0Giordano reports research grants and travel expenses from ELEKTA AB and Varian Medical Systems Inc.; grants, stocks, travel expenses, and honoraria from TME Pharma AG; research grants, travel expenses, and honoraria from Carl Zeiss Meditec AG; travel expenses and honoraria from Bristol-Myers Squibb, Cureteq AG, Guerbet SA, Roche Pharma AG, MSD Sharp and Dohme GmbH, and AstraZeneca GmbH; non-financial support from Oncare GmbH and Opasca GmbH. G.R.\u00a0Sarria reports personal fees and travel expenses from Carl Zeiss Meditec AG; personal fees from Roche Pharma AG; personal fees from MedWave Clinical Trials; and travel expenses from Guerbet SA, not related to this work. P.\u00a0Fischer, C.S.\u00a0Dejonckheere,  R.\u00a0Mispelbaum, T.\u00a0Hattenhauer, S.\u00a0Wiegreffe, A.R.\u00a0Glasmacher, K.\u00a0Layer, Y.\u00a0Nour, L.\u00a0Caglayan, F.\u00a0Grau, T.\u00a0M\u00fcdder, M.\u00a0K\u00f6ksal, D.\u00a0Scafa, A.\u00a0Lopez-Pastorini, E.\u00a0Stoelben, L.C.\u00a0Schmeel, and C.\u00a0Leitzen declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was conducted in accordance with the principles of the Declaration of Helsinki and approved by the Ethics Committee of the University Hospital Bonn (approval number: 057\/22). Informed consent was not required due to the retrospective character of this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}