Evidence supporting contemporary post-operative radiation therapy (PORT) using linear accelerators in N2 lung cancer

Patel, Suchit H.; Ma, Yan; Wernicke, A. Gabriella; Nori, Dattatreyudu; Chao, K.S.C.; Parashar, Bhupesh

doi:10.1016/j.lungcan.2014.02.016

Cited by 36 publications

(29 citation statements)

References 30 publications

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“…al found that for patients with pN2 disease PORT had an OS and LR benefit compared with for patients who did not receive PORT. 10 The 2016 update of the American National Comprehensive Cancer Network guidelines for NSCLC recommend adjuvant RT for pN2 disease with negative margins. 11 A 2015 American Society for Radiation Oncology executive summary of evidence-based clinical practice guidelines noted that high-level evidence suggested that PORT improves local control for patients with N2 disease.…”

Section: Introductionmentioning

confidence: 99%

Role of Postoperative Radiotherapy in Pathologic Stage IIIA (N2) Non–Small Cell Lung Cancer in a Prospective Nationwide Oncology Outcomes Database

Herskovic

Mauer

Christos

et al. 2017

Journal of Thoracic Oncology

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Section: Introductionmentioning

confidence: 99%

Role of Postoperative Radiotherapy in Pathologic Stage IIIA (N2) Non–Small Cell Lung Cancer in a Prospective Nationwide Oncology Outcomes Database

Herskovic

Mauer

Christos

et al. 2017

Journal of Thoracic Oncology

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“…PORT also failed to improve OS, as well as failure-free survival, in the earlier study by Perry et al [11] on resected N2 NSCLC. The results of several meta-analyses are contradictory and hence do not justify the routine use of PORT in patients with completely resected N2 NSCLC [7, 9, 12, 13]. …”

Section: Introductionmentioning

confidence: 99%

Propensity score-matching analysis of postoperative radiotherapy for stage IIIA-N2 non-small cell lung cancer using the Surveillance, Epidemiology, and End Results database

et al. 2017

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BackgroundTo investigate the effects of postoperative radiotherapy (PORT) on the survival of patients with resected stage IIIA-N2 non-small cell lung cancer (NSCLC).MethodsA total of 3,334 patients with resected stage IIIA-N2 NSCLC in 2004 to 2013 were identified in the Surveillance, Epidemiology, and End Results database and stratified according to use of PORT. Propensity score-matching (PSM) methods were used to balance the baseline characteristics of patients who did (n = 744) or did not (n = 744) undergo PORT. Overall survival (OS) and lung cancer-specific survival (LCSS) were compared between these two patient groups.ResultsAfter PSM, PORT increased OS (hazard ratio, 0.793; p = 0.001) and LCSS (hazard ratio, 0.837; p = 0.022) compared with no PORT. The OS benefit for PORT was mainly seen in patients aged <60 years (5-year OS, 35.4% versus 28.9% for PORT versus no PORT, respectively; p = 0.026) and in those who underwent lobectomy (5-year OS, 43.5% versus 34.5% for PORT versus no PORT, respectively; p = 0.001). The LCSS benefit for PORT was significant in patients undergoing lobectomy (5-year LCSS, 48.3% versus 42.3% for PORT versus no PORT, respectively; p = 0.036).ConclusionsThe survival benefits of PORT were primarily observed in patients with resected stage IIIA-N2 NSCLC who were <60 years of age or had undergone lobectomy.

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“…Similarly, SBRT regimens employed in 3 out of 7departments used several widely practiced fractionated regimens depending on the tumor location [19][20][21]. Recent data on the use of modern postoperative TRT [22] seem to overcame negative impact of historic data [23,24], since it enabled effectively concentrating on patients harboring high risk features. In Stage IIIA NSCLC, less than a half of the institutions would still consider surgical multimodality approach likely due to a number of group/society guidelines and recommendations [25,26] in spite of the fact that serious criticism and a number of aws and fallacies have been highlighted in recent years [27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Real-world Treatment Patterns of Lung Cancer- experience of Resource Restricted Country

Kiladze

Mariamidze

Jeremić

2020

Preprint

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Background:Lung cancer (LC) continues to be a significant worldwide public health issue. In recent years there have been several publications addressing specifics of LC worldwide, but none concerning Georgia- country with high number of smoking population and LC cases. We conducted the first study in Georgian population, that aims current LC practice.Methods: The aim of the study was to provide an overview of treatment of LC, with discussion situation in this field and indicating the future strategies for improved cancer care in the country. Medical, radiation and surgical oncologists providing treatment of LC in main hospitals (n=13) over the country, filled questionnaire that addressed specific information regarding the treatment aspects of LC reflecting current surgical aspects, systemic treatment and radiotherapy (RT). ResultsThere is no national screening program, while radiologic imaging is readily available. The vast majority of patients in the country present with advanced stages at diagnosis and they are treated with systemic therapy and/or RT. The surgical treatment is largely underutilized with the differences being observed among surgeons on the optimal timing and the extent of surgery, as well as role of surgery in specific clinical situations.Improved health care system, well equipped hospitals, availability of many anticancer drugs and existence of modern RT technology, are coupled with slow appearance of country-adapted guidelines and protocols as well as enforcing MDT meetings.There is limited access to expensive novel agents, psychological support and high quality palliative care. ConclusionsThere is still much work to be done, with all above steps considered mandatory to improve effectiveness and quality of care of LC patients.

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Evidence supporting contemporary post-operative radiation therapy (PORT) using linear accelerators in N2 lung cancer

Cited by 36 publications

References 30 publications

Role of Postoperative Radiotherapy in Pathologic Stage IIIA (N2) Non–Small Cell Lung Cancer in a Prospective Nationwide Oncology Outcomes Database

Role of Postoperative Radiotherapy in Pathologic Stage IIIA (N2) Non–Small Cell Lung Cancer in a Prospective Nationwide Oncology Outcomes Database

Propensity score-matching analysis of postoperative radiotherapy for stage IIIA-N2 non-small cell lung cancer using the Surveillance, Epidemiology, and End Results database

Real-world Treatment Patterns of Lung Cancer- experience of Resource Restricted Country

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