Postoperative Radiotherapy for Resected Pathological Stage IIIA–N2 Non-Small Cell Lung Cancer: A Retrospective Study of 221 Cases from a Single Institution

Abstract

After completing this course, the reader will be able to:1. Describe the present clinical practice and controversies regarding the use of PORT in resected pIIIA-pN2 NSCLC.2. Evaluate the effect of PORT on overall survival and on tumor control in this subgroup of patients.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTBackground. For patients with resected pathological stage IIIA-N2 non-small cell lung cancer (NSCLC), the role of postoperative radiotherapy (PORT) is not well defined. In this single-institutional study, we re-evaluated the effect of PORT on overall survival (OS) as well as tumor control in this subgroup of patients.

Re-evaluation of the Role of Postoperative Radiotherapy and the Impact of Radiation Dose for Non–Small-Cell Lung Cancer Using the National Cancer Database

“…Patients in the modern era are staged with brain magnetic resonance imaging and positron emission tomography/computed tomography scans before surgery, which were unavailable to clinicians in the past decades, lessening the possibility that patients are offered aggressive local therapy while simultaneously harboring metastatic disease. [18][19][20][21] The unavailability of local control information in the NCDB prohibited an assessment of the relationship between PORT and local control in this study. 4,5,7 Indeed, recent data support the assertion that PORT results in a substantial reduction in local recurrence, and that in turn this leads to an improvement in OS.…”

Fatal pneumonitis associated with postoperative intensity-modulated radiotherapy in lung cancer: Case report and review

“…Postoperative radiotherapy is capable of significantly improving the survival of patients with resected pathological stage IIIA-N2 non-small cell lung cancer (NSCLC) (9). For patients receiving postoperative radiotherapy, the appropriate dose limits are not yet clear.…”

Optimal sequencing of postoperative radiotherapy and chemotherapy in IIIA-N2 non-small cell lung cancer

“…The histology might have an influence on locoregional failure as adenocarcinoma and squamous cell carcinoma, due to the fact that squamous cell was pointed out to be a poor prognostic factor for survival (37); however the prognostic significance of the histology is yet to be defined in fully resected pN2 NSCLC (2). As the histology seemed to be evenly distributed here for both PORT & POCT and POCT alone groups, histology might not affect the…”

“…Their study is a documentation of retrospective experience revealing a PORT-first strategy with POCT in eligible (43/105) and without POCT in medically (30/105) (2,3) and their survival results of 61.3% in the patients with POCT was superior than previous series (2-5). Lee et al deserves appreciation for drawing attention to the sequencing of adjuvant treatment in IIIA-N2 NSCLC to claim the possible benefit of PORT-first strategy.…”