SYSTEMS-2: a randomised phase II study of radiotherapy dose escalation for pain control in malignant pleural mesothelioma

•A randomised phase II trial of radiotherapy dose escalation for pain control in MPM.•Comparison of 2 hypofractionated regimes (20 Gy/5# and 36 Gy/6#).•Highly conformal radiotherapy techniques used to aid safe dose escalation.•Primary outcome: pain control at week 5 at radiotherapy site.•Recruitment target: 112 patients from 10 to 15 UK centres.