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. 2015 Mar 10;33(8):870-6.
doi: 10.1200/JCO.2014.58.5380. Epub 2015 Feb 9.

Postoperative radiotherapy for pathologic N2 non-small-cell lung cancer treated with adjuvant chemotherapy: a review of the National Cancer Data Base

Cliff G Robinson  1 , Aalok P Patel  2 , Jeffrey D Bradley  2 , Todd DeWees  2 , Saiama N Waqar  2 , Daniel Morgensztern  2 , Maria Q Baggstrom  2 , Ramaswamy Govindan  2 , Jennifer M Bell  2 , Tracey J Guthrie  2 , Graham A Colditz  2 , Traves D Crabtree  2 , Daniel Kreisel  2 , Alexander S Krupnick  2 , G Alexander Patterson  2 , Bryan F Meyers  2 , Varun Puri  2
Affiliations

Postoperative radiotherapy for pathologic N2 non-small-cell lung cancer treated with adjuvant chemotherapy: a review of the National Cancer Data Base

Cliff G Robinson et al. J Clin Oncol. .

Abstract

Purpose: To investigate the impact of modern postoperative radiotherapy (PORT) on overall survival (OS) for patients with N2 non-small-cell lung cancer (NSCLC) treated nationally with surgery and adjuvant chemotherapy.

Patients and methods: Patients with pathologic N2 NSCLC who underwent complete resection and adjuvant chemotherapy from 2006 to 2010 were identified from the National Cancer Data Base and stratified by use of PORT (≥ 45 Gy). A total of 4,483 patients were identified (PORT, n = 1,850; no PORT, n = 2,633). The impact of patient and treatment variables on OS was explored using Cox regression.

Results: Median follow-up time was 22 months. On univariable analysis, improved OS correlated with younger age, treatment at an academic facility, female sex, urban population, higher income, lower Charlson comorbidity score, smaller tumor size, multiagent chemotherapy, resection with at least a lobectomy, and PORT. On multivariable analysis, improved OS remained independently predicted by younger age, female sex, urban population, lower Charlson score, smaller tumor size, multiagent chemotherapy, resection with at least a lobectomy, and PORT (hazard ratio, 0.886; 95% CI, 0.798 to 0.988). Use of PORT was associated with an increase in median and 5-year OS compared with no PORT (median OS, 45.2 v 40.7 months, respectively; 5-year OS, 39.3% [95% CI, 35.4% to 43.5%] v 34.8% [95% CI, 31.6% to 38.3%], respectively; P = .014).

Conclusion: For patients with N2 NSCLC after complete resection and adjuvant chemotherapy, modern PORT seems to confer an additional OS advantage beyond that achieved with adjuvant chemotherapy alone.

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Conflict of interest statement

Authors' disclosures of potential conflicts of interest are found in the article online at www.jco.org. Author contributions are found at the end of this article.

Figures

Fig 1.
Fig 1.
CONSORT diagram. NSCLC, non–small-cell lung cancer; PORT, postoperative radiotherapy; RT, radiotherapy.
Fig 2.
Fig 2.
(A) Kaplan-Meier overall survival stratified by use of postoperative radiotherapy (PORT). (B) Adjusted Kaplan-Meier overall survival stratified by use of PORT. Tx, therapy.
See this image and copyright information in PMC

Comment in

References

    1. Siegel R, Ma J, Zou Z, et al. Cancer statistics, 2014. CA Cancer J Clin. 2014;64:9–29. - PubMed
    1. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127:2893–2917. - PubMed
    1. Detterbeck FC, Boffa DJ, Tanoue LT. The new lung cancer staging system. Chest. 2009;136:260–271. - PubMed
    1. NSCLC Meta-analyses Collaborative Group. Arriagada R, Auperin A, et al. Adjuvant chemotherapy, with or without postoperative radiotherapy, in operable non-small-cell lung cancer: Two meta-analyses of individual patient data. Lancet. 2010;375:1267–1277. - PMC - PubMed
    1. Le Péchoux C. Role of postoperative radiotherapy in resected non-small cell lung cancer: A reassessment based on new data. Oncologist. 2011;16:672–681. - PMC - PubMed

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