Significance of postoperative radiotherapy in treatment of stage T1-2N0M0 small-cell lung cancer

Abstract

Objective To investigate the impact of postoperative radiotherapy (PORT) on the prognosis of early-stage small-cell lung cancer (SCLC). Methods The clinical data of 71 patients who were clinically diagnosed with stage T1-2N0M0 SCLC and underwent radical resection surgery in our hospital from 1997 to 2010 were retrospectively analyzed. Thirty-one patients received PORT, and fifty-five patients received preoperative or postoperative chemotherapy. The locoregional recurrence (LRR), distant metastasis, and overall survival (OS) rates were calculated using the Kaplan-Meier method. The log-rank test was used for survival difference analysis and univariate prognostic analysis. The multivariate prognostic analysis was made by the Cox regression model. Results The 5-year sample size was 32. The 5-year OS and LRR rates were 52% and 22%, respectively. PORT had no significant impact on OS rate (P=0.524). There were no significant differences in median OS and 5-year LRR rates between node-negative patients treated with and without PORT (47.3 vs. 96.8 months, P=0.561; 39% vs. 23%, P=0.934). In the node-positive patients, patients treated with PORT had a significantly higher median OS rate and a significantly lower 5-year LRR rate than those treated without PORT (66.7 vs. 34.6 months, P=0.016; 5% vs. 75%, P=0.004). The distant metastasis rate was 30% in all patients, and PORT had no significant impact on the distant metastasis rate (P=0.576). Conclusions PORT significantly reduces LRR rate and improves OS rate in node-positive patients with SCLC. However, it slightly reduces OS rate in node-negative patients. Therefore, PORT is recommended for node-positive patients with SCLC. Key words: Lung neoplasms/radiotherapy; Lung neoplasms/surgery; Prognosis