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Role of postoperative radiotherapy after curative resection and adjuvant chemotherapy for patients with pathological stage N2 non-small-cell lung cancer: a propensity score matching analysis.

作者信息

Kim Byoung Hyuck, Kim Hak Jae, Wu Hong-Gyun, Kang Chang Hyun, Kim Young Tae, Lee Se-Hoon, Kim Dong-Wan

机构信息

Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.

Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.

出版信息

Clin Lung Cancer. 2014 Sep;15(5):356-64. doi: 10.1016/j.cllc.2014.05.005. Epub 2014 Jun 6.


DOI:10.1016/j.cllc.2014.05.005
PMID:24996882
Abstract

BACKGROUND: The objective of this study was to evaluate the role of postoperative radiotherapy (PORT) in the setting of adjuvant chemotherapy for pathological stage N2 (pN2) non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: A retrospective review of 219 consecutive pN2 NSCLC patients who underwent curative surgery followed by adjuvant chemotherapy was performed. Forty-one patients additionally received PORT. Propensity scores for PORT receipt were individually calculated and used for matching to compare the outcome between patients who did (+) and did not (-) receive PORT. One hundred eleven patients in the PORT (-) group and 38 patients in PORT (+) group were matched. Clinical and pathologic characteristics were well-balanced. RESULTS: The median follow-up duration was 48 months. In the matched patients, PORT resulted in a significantly lower crude locoregional relapse (43.2% vs. 23.7%; P = .032). Also, PORT was associated with improved locoregional control (LRC) rate (5-year LRC 63.7% vs. 48.6%; P = .036), but not distant metastasis-free survival, disease-free survival (DFS), and overall survival. An exploratory subgroup analysis suggested a potential DFS benefit of PORT in patients with multiple station mediastinal lymph node metastases (5-year DFS, 43.2% vs. 16.6%; P = .037) and squamous cell carcinoma histology (5-year DFS, 70.1% vs. 23.3%; P = .011). CONCLUSIONS: Even in the setting of adjuvant chemotherapy, PORT significantly increased LRC for patients with curatively resected pN2 NSCLC. Some subgroups appear to benefit from PORT in terms of DFS and LRC. Individualized strategies based on risk factors might be considered.

摘要

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引用本文的文献

[1]
Efficacies of different postoperative radiotherapy techniques in patients with N2 non-small cell lung cancer: a meta-analysis.

Am J Transl Res. 2024-11-15

[2]
Artificial intelligence-assisted delineation for postoperative radiotherapy in patients with lung cancer: a prospective, multi-center, cohort study.

Front Oncol. 2024-10-22

[3]
Exploring the past, present, and future of postoperative radiotherapy for N2 stage non-small cell lung cancer.

Radiat Oncol J. 2023-9

[4]
Beneficial effects of postoperative radiotherapy for IIIA‑N2 non‑small cell lung cancer after radical resection analysed using the propensity score‑matching method.

Oncol Lett. 2023-4-5

[5]
Mediastinal radiotherapy after adjuvant chemotherapy for resected non-small cell lung cancer with N2 lymphadenopathy: A novel meta-analysis.

JTCVS Open. 2020-12-17

[6]
The effect of adjuvant chemoradiotherapy on survival after R0 resection for stage III-N2 nonsmall cell lung cancer: A meta-analysis.

Medicine (Baltimore). 2022-7-15

[7]
The Prognostic Role of PORT and EGFR Mutation Status in Completely Resected Stage IIIA/N2 Non-Small Cell Lung Cancer Patients with Postoperative Chemotherapy.

Pathol Oncol Res. 2021

[8]
Impact of treatment modality on long-term survival of stage IA small-cell lung cancer patients: a cohort study of the U.S. SEER database.

Ann Transl Med. 2020-10

[9]
Evaluation of Postoperative Radiotherapy Effect on Survival of Resected Stage III-N2 Non-small Cell Lung Cancer Patients.

Front Oncol. 2020-7-28

[10]
The role of postoperative radiotherapy for completely resected pIIIA-N2 non-small cell lung cancer patients with different clinicopathological features: a systemic review and meta-analysis.

J Cancer. 2019-6-24

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