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Meta-Analysis
. 2022 Jul 15;101(28):e29550.
doi: 10.1097/MD.0000000000029550.

Postoperative radiotherapy in pIIIA-N2 non-small cell lung cancer after complete resection and adjuvant chemotherapy: A meta-analysis

Shou-Feng Wang  1 , Nai-Quan Mao  1 , Wen-Hua Zhao  2 , Xin-Bin Pan  3
Affiliations
Meta-Analysis

Postoperative radiotherapy in pIIIA-N2 non-small cell lung cancer after complete resection and adjuvant chemotherapy: A meta-analysis

Shou-Feng Wang et al. Medicine (Baltimore). .

Abstract

Background: This study aimed to evaluate the effect of postoperative radiotherapy (PORT) in patients with pIIIA-N2 non-small cell lung cancer after complete resection and adjuvant chemotherapy.

Methods: Electronic databases (PubMed, Web of Science databases, Embase, and the Cochrane Central Register of Controlled Trials) were systematically searched to extract randomized control trials comparing PORT with observation in pIIIA-N2 non-small cell lung cancer patients until October 2021. Main outcomes were disease-free survival (DFS), overall survival (OS), and local recurrence.

Results: Three-phase 3 randomized control trials involving 902 patients were included: 455 patients in the PORT group and 447 patients in the observation group. The methodological quality of the 3 randomized control trials were high quality. The pooled analysis revealed that PORT decreased local recurrence rate (odds ratio = 0.56, 95% confidence interval [CI]: 0.40-0.76). However, PORT did not improve median DFS (hazard ratio = 0.84, 95% CI: 0.71-1.00) and OS (hazard ratio = 1.02, 95% CI: 0.68-1.52).

Conclusions: PORT decreased the incidence of local recurrence. However, PORT did not improve DFS and OS.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flowchart depicting study selection.
Figure 2.
Figure 2.
Risk of bias assessment of included studies. ART = adjuvant radiotherapy, CALGB = cancer and Leukemia Group B, PORT-C = postoperative radiotherapy-China.
Figure 3.
Figure 3.
Forest plot of HR of median disease-free survival between postoperative radiotherapy and observation groups. ART = adjuvant radiotherapy, CALGB = cancer and Leukemia Group B, CI = confidence interval, HR = hazard ratio, PORT = postoperative radiotherapy, PORT-C = postoperative radiotherapy-China, seTE = standard error of treatment estimate, TE = treatment estimate.
Figure 4.
Figure 4.
Forest plot of HR of median overall survival between postoperative radiotherapy and observation groups. CALGB = cancer and Leukemia Group B, CI = confidence interval, HR = hazard ratio, PORT = postoperative radiotherapy, PORT-C = postoperative radiotherapy-China, seTE = standard error of treatment estimate, TE = treatment estimate.
Figure 5.
Figure 5.
Forest plot of OR of local recurrence between postoperative radiotherapy and observation groups. ART = adjuvant radiotherapy, CALGB = cancer and Leukemia Group B, CI = confidence interval, OR = odds ratio, PORT = postoperative radiotherapy, PORT-C = postoperative radiotherapy-China.
Figure 6.
Figure 6.
Forest plot of OR of distant metastasis between postoperative radiotherapy and observation groups. ART = adjuvant radiotherapy, CALGB = cancer and Leukemia Group B, CI = confidence interval, OR = odds ratio, PORT = postoperative radiotherapy, PORT-C = postoperative radiotherapy-China.
Figure 7.
Figure 7.
Forest plot of OR of brain metastasis between postoperative radiotherapy and observation groups. ART = adjuvant radiotherapy, CALGB = cancer and Leukemia Group B, CI = confidence interval, OR = odds ratio, PORT = postoperative radiotherapy.
Figure 8.
Figure 8.
Forest plot of OR of death due to cancer between postoperative radiotherapy and observation groups. ART = adjuvant radiotherapy, CI = confidence interval, OR = odds ratio, PORT = postoperative radiotherapy, PORT-C = postoperative radiotherapy-China.
Figure 9.
Figure 9.
Forest plot of OR of treatment related adverse events of grade 3 or higher between postoperative radiotherapy and observation groups. ART = adjuvant radiotherapy, CI = confidence interval, OR = odds ratio, PORT = postoperative radiotherapy, PORT-C = postoperative radiotherapy-China.
Figure 10.
Figure 10.
The final conclusion of this meta-analysis. AE = adverse event, DFS = disease-free survival, NSCLC = non–small cell lung cancer, OS = overall survival, PORT = postoperative radiotherapy.
See this image and copyright information in PMC

References

    1. Sung H, Ferlay J, Siegel RL, et al. . Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–49. - PubMed
    1. Goldstraw P, Chansky K, Crowley J, et al. . The IASLC Lung Cancer Staging Project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer. J Thorac Oncol. 2016;11:39–51. - PubMed
    1. Betticher DC, Hsu Schmitz SF, Totsch M, et al. . Prognostic factors affecting long-term outcomes in patients with resected stage IIIA pN2 non-small-cell lung cancer: 5-year follow-up of a phase II study. Br J Cancer. 2006;94:1099–106. - PMC - PubMed
    1. Douillard JY, Rosell R, De Lena M, et al. . Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB-IIIA non-small-cell lung cancer (Adjuvant Navelbine International Trialist Association [ANITA]): a randomised controlled trial. Lancet Oncol. 2006;7:719–27. - PubMed
    1. Arriagada R, Bergman B, Dunant A, et al. . Cisplatin-based adjuvant chemotherapy in patients with completely resected non-small-cell lung cancer. N Engl J Med. 2004;350:351–60. - PubMed

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