British Thoracic Society Guideline for the investigation and management of malignant pleural mesothelioma

The decision tree analysis scoring systems is likely to be the most useful in routine clinical practice. First-line clinical trials are an appropriate option for patients with good PS and are recommended above any other option for second-line treatment, providing the patient is of adequate PS. Grade D. Research recommendations Prospective clinical trials of preoperative radiotherapy, postoperative radiotherapy after pleurectomy decortication and definitive radiotherapy after chemotherapy in MPM are required. [...]prospective randomised clinical trials are required to determine the role of radiotherapy for symptom control in MPM and the optimal dose fractionation.