Non-small cell lung cancer: radiation therapy for locoregional recurrence after complete resection

Abstract

Postoperative recurrent non-small cell lung cancer showed distinctive features: the response rate was high, and the incidence of marginal relapse was also high, as in small cell lung cancer. The incidence of lower marginal relapse was high, in contrast to that in surgery-naive patients.

Comparative Survival in Patients With Postresection Recurrent Versus Newly Diagnosed Non–Small-Cell Lung Cancer Treated With Radiotherapy

“…The 5-year and median OS results for those with recurrence in our study appeared to be better than those reported by others, which have ranged from 4% to 12.5% and 8.1 to 14.0 months, respectively (9)(10)(11)(12)(13)(14)(15)(16)(17), and the survival of the newly diagnosed patients was comparable to those reported for 1996-2004 in the 17 Surveillance, Epidemiology, and End Results geographic areas (5-year survival rate, 15.2%; available from: http://seer.cancer.gov/statfacts/html/lungb. html).…”

“…The data on treatment outcomes after RT are limited for postresection recurrent NSCLC (9)(10)(11)(12)(13)(14)(15)(16)(17), especially relative to the survival outcomes of newly diagnosed NSCLC patients treated with RT-based regimens (10,11). The purpose of the present study was to evaluate the utility of salvage RT for recurrent NSCLC after surgical resection and to compare the survival statistics of these patients with those of newly diagnosed NSCLC patients.…”

The role of routine bronchoscopy for early detection of bronchial stump recurrence of lung cancer—1 year post-surgery

“…Previous studies have shown 5-20% local recurrence rate [19][20][21][22][23][24][25]. In these series, 23% of local recurrence were at the bronchial stump [19] and 30% in the involved lung and mediastinum [9].…”

“…In these series, 23% of local recurrence were at the bronchial stump [19] and 30% in the involved lung and mediastinum [9]. Jang et al have reported that stump recurrence occurred only in squamous cell carcinoma and comprised 11% of the local recurrence rate across 6 years follow up [26].…”

Therapeutic strategy for postoperative recurrence in patients with non-small cell lung cancer

“…The administration of modern three-dimensional conformal radiotherapy with a curative dose of 60-66 Gy has been reported to achieve approximately 90% response rate (65% complete response and 24% partial response) for postoperative thoracic lymph node recurrence [37] . As a result, the five-year PFS and OS rates are 22.2% and 36.1%, respectively, Postoperative locoregional recurrence is considered to be pathophysiologically the same as originally nonresectable stage ⅢA and ⅢB diseases, although the MST after treatment of a curative dose of radiation is longer for patients with postoperative locoregional recurrence (ranging from 14 mo to 19 mo [38][39][40] ) than for nonresectable stage ⅢA and ⅢB diseases (ranging from 8.5 to 14.1 mo [41] ). The therapeutic outcomes of the nonresectable stage ⅢA and ⅢB disease have been improved with recent developments in chemoradiotherapy, particularly platinum-based regimens, compared with that achieved with radiation alone [41] .…”