PIT: Prophylactic Irradiation of Tracts in Patients With Malignant Pleural Mesothelioma

Inclusion Criteria: * Either sex, age ≥ 18 years * Diagnosis of mesothelioma by multi-disciplinary team (MDT). All histological subtypes are eligible for the trial * ECOG performance status 0-2 (Appendix C) * Inoperable disease or operable disease in patients unsuitable for surgery as decided by a MDT * Chest wall intervention with video-assisted thoracoscopy (VATS), open surgical biopsy (mini-thoracotomy), local anaesthetic thoracoscopy or chest drain * Able to start radiotherapy within 42 days (6 weeks) of the most recent chest wall procedure * Chest wall intervention scar visible at time of randomisation * Radiotherapy target volume acceptable by the local radiotherapist * Patients enrolled on other clinical trials could be considered after discussion with the chief investigators Exclusion Criteria: * Patients who underwent a thoracotomy (as large thoracotomy scars may not be adequately covered by this radiotherapy technique) * Previous radiotherapy to the region of the chest wall intervention site * Indwelling pleural catheter in-situ at the intervention site * Patients currently receiving chemotherapy