Abstract
BackgroundThere were few reports of postoperative radiotherapy (PORT) in stage pIII-N2 Non-small-cell Lung Cancer (NSCLC) patients receiving pneumonectomy followed by adjuvant chemotherapy. This study aims to evaluate safety and efficacy of PORT among these patients.MethodsBetween Jan. 2004 and Dec. 2015, stage pIII-N2 NSCLC patients receiving pneumonectomy and adjuvant chemotherapy with or without PORT in our institution were retrospectively reviewed.ResultsTotally 119 patients were included, 32 patients receiving adjuvant chemotherapy and PORT (PORT group) and 87 receiving adjuvant chemotherapy alone (Control group). There were more patients with non-R0 resection in PORT group than Control group (25% vs. 8%, p = 0.031). In PORT group, ≥Grade 2 radiation-induced pneumonitis was 2/32. No severe radiation-related heart injury was observed. There was no PORT-related death. Of all patients, median follow-up time was 25 months. Median overall survival time (mOS) and median disease-free survival time (mDFS) were 46 months and 15 months, respectively. The PORT group had significantly better OS (not reached vs. 34 months, p = 0.003), DFS (19 months vs. 13 months, p = 0.024), local recurrence free survival (LRFS, p = 0.012), and distant metastasis free survival (DMFS, p = 0.047) than the Control group. As for failure pattern, PORT significantly reduced local regional failure rate (39.1% vs. 15.6%, p = 0.016). In subgroup analysis, patients with R0 resection (n = 104), OS and LRFS in PORT group were significantly longer, and PORT tended to increase DFS and DMFS.ConclusionFor patients with stage pIII-N2 NSCLC after pneumonectomy and adjuvant chemotherapy, PORT can improve OS, DFS, LRFS and DMFS with tolerable toxicity.
Highlights
There were few reports of postoperative radiotherapy (PORT) in stage pIII-N2 Non-small-cell Lung Cancer (NSCLC) patients receiving pneumonectomy followed by adjuvant chemotherapy
For patients with stage pIII-N2 non-small-cell lung cancer (NSCLC) after surgery followed by adjuvant chemotherapy, postoperative radiotherapy (PORT) is a major treatment modality
For stage pIII-N2 NSCLC after pneumonectomy followed by adjuvant chemotherapy, the results showed good compliance and safety of PORT without any severe radiation pneumonitis and esophagitis
Summary
There were few reports of postoperative radiotherapy (PORT) in stage pIII-N2 Non-small-cell Lung Cancer (NSCLC) patients receiving pneumonectomy followed by adjuvant chemotherapy. This study aims to evaluate safety and efficacy of PORT among these patients. For patients with stage pIII-N2 non-small-cell lung cancer (NSCLC) after surgery followed by adjuvant chemotherapy, postoperative radiotherapy (PORT) is a major treatment modality. Pneumonectomy is still an important therapeutic option for central, giant mass or tumors involving main bronchus or large blood vessels [5,6,7], which may bring benefits to survival [8]. For patients with stage pIII-N2 NSCLC after pneumonectomy and adjuvant chemotherapy, safety and efficacy of PORT needs to be evaluated. The study aimed to evaluate the safety and efficacy of PORT for patients with stage pIII-N2 NSCLC after pneumonectomy and adjuvant chemotherapy
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