Post-Operative Radiation Therapy (PORT) in Completely Resected Non-Small-Cell Lung Cancer

Krupitskaya, Yelena; Loo, Billy W.

doi:10.1007/s11864-009-0090-8

Cited by 7 publications

(4 citation statements)

References 55 publications

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“…The clinical value of postoperative radiotherapy (PORT) in stage N2 non-small-cell lung cancer (NSCLC) is controversy [30]. Postoperative radiotherapy may be considered for fit patients with completely resected NSCLC with N2 nodal involvement, preferably after the completion of adjuvant chemotherapy [31]. A large multi-institutional randomized trial of PORT in these patient populations is now underway.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance in the number of involved lymph nodes in patients that underwent surgery for pathological stage III-N2 non-small cell lung cancer

Hanagiri

Takenaka

Oka

et al. 2011

J Cardiothorac Surg

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PurposeThis study investigated whether the number of involved lymph nodes is associated with the prognosis in patients that underwent surgery for pathological stage (p-stage) III/N2 NSCLC.SubjectsThis study evaluated 121 patients with p-stage III/N2 NSCLC.ResultsThe histological types included 65 adenocarcinomas, 39 squamous cell carcinomas and 17 others. The average number of dissected lymph nodes was 23.8 (range: 6-55). The average number of involved lymph nodes was 5.9 (range: 1-23). The 5-year survival rate of the patients was 51.0% for single lymph node positive, 58.9% for 2 lymph nodes positive, 34.2% for 3 lymph nodes positive, and 30.0% for 4 lymph nodes positive, and 20.4% for more than 5 lymph nodes positive. The patients with either single or 2 lymph nodes positive had a significantly more favorable prognosis than the patients with more than 5 lymph nodes positive. A multivariate analysis revealed that the number of involved lymph nodes was a significant independent prognostic factor.ConclusionSurgery appears to be preferable as a one arm of multimodality therapy in p-stage III/N2 patients with single or 2 involved lymph nodes. The optimal incorporation of surgery into the multimodality approach therefore requires further clinical investigation.

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Section: Discussionmentioning

confidence: 99%

Clinical significance in the number of involved lymph nodes in patients that underwent surgery for pathological stage III-N2 non-small cell lung cancer

Hanagiri

Takenaka

Oka

et al. 2011

J Cardiothorac Surg

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“…When administered postoperatively, radiation therapy doses after complete resection tend to be slightly higher at 50 to 54 Gy in most series. 44 For either pre-or postoperative radiation therapy, nodal targets can be extrapolated from known patterns of nodal spread [45][46][47] and regional failure after surgery for earlier-stage NSCLC. 48 Higher doses have been avoided historically because of the higher risk of postoperative complications, such as bronchopleural fistula and respiratory distress.…”

Section: Radiation Therapy Technique Recommendationsmentioning

confidence: 99%

The Management of Patients With Stage IIIA Non–Small Cell Lung Cancer With N2 Mediastinal Node Involvement

Martins¹,

D’Amico

Loo³

et al. 2012

J Natl Compr Canc Netw

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Patients with stage IIIA non-small cell lung cancer, determined based on involvement of ipsilateral mediastinal lymph nodes, represent the most challenging management problem in this disease. Patients with this stage disease may have very different degrees of lymph node involvement. The pathologic confirmation of this involvement is a key step in the therapeutic decision. The difference in the degree of lymph node compromise has prognostic and treatment implications. Based on multiple considerations, patients can be treated with induction chemotherapy, chemoradiotherapy followed by surgery, or definitive chemoradiotherapy without surgery. Data derived from clinical trials have provided incomplete guidance for physicians and their patients. The best therapeutic plan is achieved through the multidisciplinary cooperation of a team specialized in lung cancer.

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“…[45,46] It is thought that the efficacy of the resection margin in stage III disease is unclear because distant metastases are leading in this patient group. [47] In summary, PORT is recommended in patients with N2 disease and positive surgical margins. Radiotherapy is recommended to be administered after adjuvant CT as a total of 50-54 Gy of 1.8-2 Gy fractions.…”

Section: Post-operative Radiotherapy In Non-small Cell Lung Cancer (Pmentioning

confidence: 99%

Radiotherapy in Lung Cancer: Current and Future Role

2019

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L ung cancer is known to be the most commonly diagnosed cancer with high mortality and morbidity. Lung cancer is divided into two groups as non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). These two groups should be seen as two different diseases concerning their clinical course. 80-85% of newly diagnosed lung cancer patients are NSCLC, and 15-20% is SCLC. According to Turkey cancer statistics in 2017, lung cancer is the first in cancer rate in men (52.5/100.000) and the fifth most common type of cancer in women (8.7/100000). 1-The Role of Radiotherapy in Non-Small Cell Lung Cancer Non-small cell lung cancer (NSCLC), which forms the majority of lung cancers, consists of squamous cell cancer, adenocarcinoma and large cell cancers. Although surgical resection is curative in the group without severe concomitant disease at the early-stage, radiosurgery has taken its place as the standard treatment approach in patients with comorbid disease. However, this group covers only 30% of the patients. [1, 2] Radiotherapy can be applied as definitive in the group with local and regional advanced disease with no surgical chance, as neoadjuvant in the group that has the potential to have surgery and can be applied as adjuvant considering some risk factors after surgery. Radiotherapy in metastatic disease is often used for palliative purposes, but radiosurgery may be an option for metastases in oligometastatic disease. 1A-Early Stage (I-II) Stereotactic Body Radiotherapy or Lung Radiosurgery Radiosurgery, which was introduced to our practice by Swedish brain surgeon Lars Leksell in 1950, was first used in the treatment of brain lesions. With the development Lung cancer is divided into two subgroups concerning its natural course and treatment strategies as follows: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). In this review, for NSCLC, the role of stereotactic body radiation therapy (SBRT) in early-stage, chemoradiation in the locally advanced stage, post-operative radiotherapy for patients with high risk after surgery and radiotherapy for metastatic disease will be discussed. Also, for SCLC, the role and timing of thoracic irradiation and prophylactic cranial irradiation (PCI) for the limited and extensive stages will be discussed.

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Post-Operative Radiation Therapy (PORT) in Completely Resected Non-Small-Cell Lung Cancer

Cited by 7 publications

References 55 publications

Clinical significance in the number of involved lymph nodes in patients that underwent surgery for pathological stage III-N2 non-small cell lung cancer

Clinical significance in the number of involved lymph nodes in patients that underwent surgery for pathological stage III-N2 non-small cell lung cancer

The Management of Patients With Stage IIIA Non–Small Cell Lung Cancer With N2 Mediastinal Node Involvement

Radiotherapy in Lung Cancer: Current and Future Role

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