
    lack of accrual
  
['malignant pleural mesothelioma']
['pemetrexed/cisplatin']

        Inclusion Criteria:

          -  Pathologically confirmed diagnosis of malignant pleural mesothelioma at MSKCC

          -  No plans for surgical resection

          -  Stage T1-4, N0-3, M0

          -  No prior radiation therapy to the chest, breast or supraclavicular fossa that would
             limit radiation delivery to the full prescription dose

          -  Prior chemotherapy regimens ≤1

          -  Age ≥18 years

          -  Karnofsky performance status ≥ 80%

          -  Pulmonary function tests as follows: DLCO>50% predicted

          -  Adequate hematologic, hepatic, and renal function as indicated by the following
             laboratory values

               -  Absolute neutrophil count ≥ 1,500/mcL

               -  Platelets ≥ 100,000/mcL

               -  Calculated creatinine clearance (CrCl) ≥ 45mL/min (using Cockcroft & Gault
                  method)

               -  Serum total bilirubin ≤ 1.5 x upper limit of normal (ULN) (unless known Gilbert's
                  disease)

               -  AST (SGOT) and ALT (SGPT) ≤ 3.0 x ULN

        Exclusion Criteria:

          -  Pregnant or lactating women, or men or women not using effective contraception

          -  Patients with an active infection that requires systemic antibiotics, antiviral, or
             antifungal treatments

          -  Patients with a concurrent active malignancy (with the exception of skin cancer)

          -  Patients with serious unstable medical illness

          -  Patients with idiopathic pulmonary fibrosis

          -  Patients with NYHA heart failure class >2

          -  Patients with only one kidney that is ipsilateral to the mesothelioma

          -  Implanted pacemaker and/or defibrillator ipsilateral to the mesothelioma if it cannot
             be moved

          -  Patients meeting the following exclusion criteria will be excluded from the MRI
             portion only:

          -  Metallic implant, e.g. pacemaker, defibrillator

          -  Unmanageable claustrophobia

          -  High risk for nephrogenic systemic fibrosis
      