Abstract

In this retrospective study, we developed nomograms for predicting the efficacy of post-operation radiotherapy (PORT) in IIIA-N2 non-small cell lung cancer (NSCLC) patients. In total, 334 patients received post-operational chemotherapy and were included in the analysis. Of those, 115 also received either concurrent or sequential post-operational radiotherapy (PORT). Nomograms were developed using Cox proportional hazard regression models to identify clinicopathological characteristics that predicted progression free survival (PFS) and overall survival (OS), and subgroup analyses of the effects of PORT were performed using nomogram risk scores. PFS and OS predicted using the nomogram agreed well with actual PFS and OS, and patients with high PFS/OS nomogram scores had poorer prognoses. In subgroup analyses, PORT increased survival more in patients with low PFS nomogram risk scores or high OS nomogram risk scores. Thus, our novel nomogram risk score model predicted PFS, OS, and the efficacy of PORT in IIIA-N2 NSCLC patients.

Highlights

  • Patients with stage IIIA pN2 non-small cell lung cancer (NSCLC) differ in clinicopathologic characteristics and in the risk of local recurrence and metastasis after complete resections

  • We developed nomograms for predicting the efficacy of post-operation radiotherapy (PORT) in IIIA-N2 non-small cell lung cancer (NSCLC) patients

  • We developed a nomogram based on clinical features for predicting prognosis and the value of PORT for treating stage IIIA-N2 NSCLC patients

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Summary

Introduction

Patients with stage IIIA pN2 non-small cell lung cancer (NSCLC) differ in clinicopathologic characteristics and in the risk of local recurrence and metastasis after complete resections. The efficacy of postoperative chemotherapy (POCT) after complete resection has been confirmed in stage II and III NSCLC patients [3,4,5], the value of post-operative radiotherapy (PORT) in these patients remains controversial [1, 2]. The Adjuvant Navelbine International Trialist Association (ANITA) trial confirmed that PORT was associated with better overall survival (OS) in patients with resected pN2 NSCLC [8]. Additional studies are needed to confirm the efficacy of PORT for treating IIIA-pN2 NSCLC patients. A robust prognostic model for predicting prognosis would help determine the efficacy of PORT in IIIA-N2 NSCLC patients. We developed a nomogram based on clinical features for predicting prognosis and the value of PORT for treating stage IIIA-N2 NSCLC patients

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