{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T11:00:36Z","timestamp":1787655636395,"version":"build-2736575974"},"reference-count":33,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondazione Oxiamo Onlus","award":["KDN 102"],"award-info":[{"award-number":["KDN 102"]}]},{"name":"Fondazione Oxiamo Onlus","award":["KDN 103"],"award-info":[{"award-number":["KDN 103"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: This multicenter retrospective study aims to evaluate the role of Ablative Radiotherapy (RT) in patients with unresectable pleural mesothelioma (PM) who experienced radiological progression after at least one line of chemotherapy, with a maximum involvement of three pleural or extrapleural sites. Methods: Adult patients (\u226518 years) with PM treated with stereotactic radiotherapy between 2011 and 2022, limited to a maximum of three pleural or extrapleural sites, were included in the analysis. Ablative RT was required to be administered with radical intent. Endpoints were time to further systemic therapy (TFST), local control (LC), progression-free survival (PFS), overall survival (OS), and acute and late radiotherapy-related toxicity. Results: A total of 56 patients were identified from six Italian and one Swiss radiotherapy center. Treatment was generally well tolerated. Ten patients experienced grade 1 or 2 acute toxicity, while four patients reported persistent chest pain, with one case reaching grade 3 as late toxicity. The median TFST was 18.6 months, with TFST rates of 61.7% and 46.4% at 12 and 24 months, respectively. The median OS was 37.63 months, with 1- and 2-year OS rates of 85.2% and 65.6%. Local control was favorable (79% at 1 year), but most patients experienced disease recurrence outside the SABR treatment volume. The median disease progression-free survival (DPFS) was 8.17 months, with 1- and 2-year DPFS rates of 36% and 19%, respectively. Smoking history correlated with OS and DPFS in univariate analysis, while statistical significance for OS was maintained in multivariate analysis. Additionally, nodal status and PTV volume were associated with OS. Conclusion: SABR is a safe and effective approach for the treatment of oligorecurrent\/oligoprogressive PM. The time to further systemic therapy was extended up to 18 months. At two years, 10% of patients remained disease-free, and more than half were alive at three years, suggesting a potentially indolent biological behavior in oligometastatic PM.<\/jats:p>","DOI":"10.3390\/cancers17172797","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T15:49:34Z","timestamp":1756309774000},"page":"2797","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Oligometastatic Mesothelioma Treated with Ablative Radiotherapy (OMAR): A Multicenter Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1142-2439","authenticated-orcid":false,"given":"Davide","family":"Franceschini","sequence":"first","affiliation":[{"name":"Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Ghirardelli","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Cliniche Humanitas Gavazzeni, via Gavazzeni 21, 24125 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Frrokaj","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital Zurich, University of Zurich, R\u00e4mistrasse 100, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolaus H.","family":"Andratschke","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital Zurich, University of Zurich, R\u00e4mistrasse 100, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0731-8041","authenticated-orcid":false,"given":"Luca","family":"Nicosia","sequence":"additional","affiliation":[{"name":"Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, 37034 Negrar Di Valpolicella, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Parisi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5358-1297","authenticated-orcid":false,"given":"Gaia","family":"Piperno","sequence":"additional","affiliation":[{"name":"Division of Radiotherapy, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9654-5587","authenticated-orcid":false,"given":"Matteo","family":"Sepulcri","sequence":"additional","affiliation":[{"name":"Radiation Therapy Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Al\u00ec","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2549-4583","authenticated-orcid":false,"given":"Antonio Marco","family":"Marzo","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Bendoni","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruggero","family":"Spoto","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2064-8379","authenticated-orcid":false,"given":"Marco","family":"Krengli","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Universit\u00e0 di Padova e Istituto Oncologico Veneto\u2014IRCCS, 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Ciammella","sequence":"additional","affiliation":[{"name":"Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8151-3673","authenticated-orcid":false,"given":"Barbara A.","family":"Jereczek-Fossa","sequence":"additional","affiliation":[{"name":"Division of Radiotherapy, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy"},{"name":"Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Romeo","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) \u201cDino Amadori\u201d, 47014 Meldola, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Mazzola","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Cliniche Humanitas Gavazzeni, via Gavazzeni 21, 24125 Bergamo, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6569-8628","authenticated-orcid":false,"given":"Filippo","family":"Alongi","sequence":"additional","affiliation":[{"name":"Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, 37034 Negrar Di Valpolicella, Italy"},{"name":"University of Brescia, 25121 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Guckenberger","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Hospital Zurich, University of Zurich, R\u00e4mistrasse 100, 8091 Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8599-0629","authenticated-orcid":false,"given":"Giovanni Luca","family":"Ceresoli","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Cliniche Humanitas Gavazzeni, via Gavazzeni 21, 24125 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Loi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Azienda Universitaria Ospedaliera Careggi, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7275-7908","authenticated-orcid":false,"given":"Paolo","family":"Borghetti","sequence":"additional","affiliation":[{"name":"Radiation Oncology Department, ASST Spedali Civili and University of Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0320-559X","authenticated-orcid":false,"given":"Marta","family":"Scorsetti","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"ref_1","first-page":"402","article-title":"Mesothelioma: Scientific clues for prevention, diagnosis, and therapy","volume":"69","author":"Carbone","year":"2019","journal-title":"CA Cancer J. 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