Radiation Therapy–First Strategy After Surgery With or Without Adjuvant Chemotherapy in Stage IIIA-N2 Non-Small Cell Lung Cancer

Journal Article · Tue Mar 01 04:00:00 EST 2016 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2015.11.020· OSTI ID:22645113

Lee, Hyun Woo ^[1]; Oh, Young-Taek ^[2]; Choi, Jin-Hyuk ^[1]; Chun, Mison; Kim, Hwan-Ik; Heo, Jaesung ^[2]; Ahn, Mi Sun ^[1]; Park, Seong Yong ^[3]; Park, Rae Woong; Yoon, Dukyong ^[4]

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1. Department of Hematology-Oncology, Ajou University School of Medicine, Suwon (Korea, Republic of)
2. Department of Radiation Oncology, Ajou University School of Medicine, Suwon (Korea, Republic of)
3. Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon (Korea, Republic of)
4. Department of Biomedical Informatics, Ajou University School of Medicine, Suwon (Korea, Republic of)

Purpose: Postoperative radiation therapy (PORT) and postoperative chemotherapy (POCT) can be administered as adjuvant therapies in patients with non-small cell lung cancer (NSCLC). The aim of this study was to present the clinical outcomes in patients treated with PORT-first with or without subsequent POCT in stage IIIA-N2 NSCLC. Methods and Materials: From January 2002 to November 2014, the conditions of 105 patients with stage IIIA-N2 NSCLC who received PORT-first with or without subsequent POCT were analyzed. PORT was initiated within 4 to 6 weeks after surgical resection. Platinum-based POCT was administered 3 to 4 weeks after the completion of PORT. We analyzed the outcomes and the clinical factors affecting survival. Results: Of 105 patients, 43 (41.0%) received POCT with a median of 4 cycles (range, 2-6 cycles). The follow-up times ranged from 3 to 123 months (median, 30 months), and the 5-year overall survival (OS) was 40.2%. The 5-year OS of patients treated with PORT and POCT was significantly higher than that of patients with PORT (61.3% vs 29.2%, P<.001). The significant prognostic factors affecting OS were the use of POCT (hazard ratio [HR] = 0.453, P=.036) and type of surgery (pneumonectomy/lobectomy; HR = 2.845, P<.001). Conclusions: PORT-first strategy after surgery appeared not to compromise the clinical outcomes in the treatment of stage IIIA-N2 NSCLC. The benefit of POCT on OS was preserved even in the PORT-first setting. Further studies are warranted to compare the sequencing of PORT and POCT, guaranteeing the proper use of POCT.

• OSTI ID: 22645113
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 94; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
LUNGS
NEOPLASMS
PATIENTS
RADIOTHERAPY
SURGERY