Is there a role for prophylactic radiotherapy to intervention tract sites in patients with malignant pleural mesothelioma?

Malignant pleural mesothelioma is an aggressive malignancy arising from the pleural lining, with a strong causal link to prior asbestos use (1). Despite a significant reduction in its use in many countries worldwide, the long latency period between asbestos exposure and disease has led to an increased incidence over the last 20 years, with over 2,500 deaths in the UK alone in 2015 (2,3). Mesothelioma causes significant morbidity to patients, including dyspnoea (often related to malignant pleural effusion), systemic symptoms and chest pain (4,5). It is invariably fatal, with a median survival of approximately 1 year from diagnosis (6)