Last year in the UK over 60,000 cancer patients enrolled on clinical trials aimed at improving cancer treatments and making them available to all.
A trial looking at radiotherapy to prevent spread of mesothelioma after a chest wall procedure (SMART trial)
This trial looked at the use of radiotherapy to prevent the spread of mesothelioma after having a procedure to the chest wall.
This trial was for people whose mesothelioma started in the two sheets of tissue known as pleural membranes (or pleura) that cover the lungs (pleural mesothelioma).
More about this trial
When this trial was done, people with pleural mesothelioma sometimes had radiotherapy to the area where they had a small tissue sample taken or fluid drained.
Some doctors thought this might stop the mesothelioma cells growing in the scar tissue. Radiotherapy was done as soon after the procedure as possible.
Research showed that mesothelioma spreading to the chest wall (a chest wall
In this trial, researchers compared giving radiotherapy very soon after a chest wall procedure with giving it only if the mesothelioma had spread into or around the scar tissue.
The aims of this study were to:
- find the best time to give radiotherapy to lower the risk of mesothelioma spreading
- learn more about side effects, chest pain levels and
quality of life
Summary of results
The trial team found that giving radiotherapy to everyone after a chest wall procedure wasn’t useful and didn’t lower the chances of the mesothelioma spreading to that area.
203 people took part in this trial. They were put into 1 of 2 groups at random.
- 102 had radiotherapy soon after the chest wall procedure (within 42 days)
- 101 only had radiotherapy if the mesothelioma spread to the procedure site
Those having radiotherapy had it once a day for 3 days.
A year after people joined the trial, the trial team looked at the number of people who had developed mesothelioma in the chest wall within 7cm of the procedure site. They found no significant difference between the 2 groups.
They also looked at:
- quality of life
- pain scores and how many people reported chest pain or needed pain control drugs
They found no difference between the 2 groups in either of these. The researchers say this suggests that having radiotherapy straight away doesn’t help symptom control.
The main side effects of radiotherapy were:
- skin reactions such as redness and irritation
The trial team concluded that having radiotherapy soon after a chest wall procedure wasn’t useful and didn’t prevent the mesothelioma spreading to the procedure site.
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (
How to join a clinical trial
Professor Nick Maskell
Dr Amelia Clive
NIHR Clinical Research Network: Cancer
NIHR Research for Patient Benefit (RfPB) Programme
North Bristol NHS Trust