Postresection Irradiation for Primary Lung Cancer

Green, Nathan; Kurohara, Samuel S.; George, Frederick W.; Crews, Quintous E.

doi:10.1148/116.2.405

Cited by 103 publications

(11 citation statements)

References 6 publications

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“…More recently, Walsh et al 12 reported local recurrences in 14 of 121 patients (12%) with reas shown by many previous retrospective and prospective studies, [1][2][3][4][5] but also may improve survival for sected Stage III disease. However, these results were reported as crude rates of local recurrence (not actuarpatients with nonsmall cell lung carcinoma with involvement of N2 lymph nodes.…”

Section: Discussionmentioning

confidence: 93%

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node number.

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mentioning

confidence: 99%

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The impact of surgical adjuvant thoracic radiation therapy for patients with nonsmall cell lung carcinoma with ipsilateral mediastinal lymph node involvement

Sawyer

Bonner

Gould

et al. 1997

Cancer

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RESULTS.The median follow-up time was 3.5 years for the patients who were alive Hongzhe Li, Ph.D. 4 at the time of the analysis. The surgery alone versus surgery plus TRT groups were 1 Division of Radiation Oncology, well balanced with respect to gender, age, histology, tumor grade, number of Mayo Clinic and Mayo Foundation, Rochester, mediastinal lymph node stations dissected or involved, and involved N1 lymph Minnesota.node number. There were slightly more patients with right lower lobe lesions 2 Division of Thoracic and Cardiovascular Sur-(compared with other lobes), patients with multiple lobe involvement, and patients gery, Mayo Clinic and Mayo Foundation, Rochwith only one N2 lymph node involved in the surgery alone group. After treatment ester, Minnesota.with surgery alone, the actuarial 4-year local recurrence rate was 60%, compared 3 Division of Medical Oncology, Mayo Clinic and with 17% for treatment with adjuvant TRT (P õ 0.0001). The actuarial 4-year Mayo Foundation, Rochester, Minnesota.survival rate was 22% for treatment with surgery alone, compared with 43% for 4 Section of Biostatistics, Mayo Clinic and Mayo treatment with adjuvant TRT (P Å 0.005). On multivariate analysis, the addition Foundation, Rochester, Minnesota.of TRT (P Å 0.0001), absence of superior mediastinal lymph node involvement (P Å 0.005), and fewer N1 lymph nodes involved (P Å 0.02) were independently associated with improved survival rate.CONCLUSIONS. This study, which to the authors' knowledge is the largest evaluating adjuvant TRT in N2 nonsmall cell lung carcinoma, suggests that adjuvant TRT may improve local control and survival.

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Section: Discussionmentioning

confidence: 93%

“…

node number.

…”

mentioning

confidence: 99%

The impact of surgical adjuvant thoracic radiation therapy for patients with nonsmall cell lung carcinoma with ipsilateral mediastinal lymph node involvement

Sawyer

Bonner

Gould

et al. 1997

Cancer

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“…The risk for local recurrence is lower with PORT (25%-35%), as shown in several retrospective studies listed in Table 1 [13][14][15][16][17][18][19]. In most of these studies, there was a historical comparison with patients who had no PORT, so these figures should be interpreted with caution.…”

Section: Studies Evaluating Portmentioning

confidence: 99%

Role of Postoperative Radiotherapy in Resected Non-Small Cell Lung Cancer: A Reassessment Based on New Data

Péchoux

2011

The Oncologist

117

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After completing this course, the reader will be able to: 1. Identify patients with non-small cell lung cancer who may benefit from postoperative radiotherapy based upon current evidence. 2. Summarize the results of analyses of both older and more recent data regarding postoperative radiotherapy in NSCLC patients. ABSTRACT In completely resected non-small cell lung cancer (NSCLC) patients with pathologically involved mediasti-nal lymph nodes (N2), administration of adjuvant platinum based chemotherapy is now considered the standard of care, based on level 1 evidence. The role of postoperative radiation therapy (PORT) in this group of patients remains controversial. The PORT meta-analysis published in 1998 concluded that adjuvant radiotherapy was detrimental to patients with early-stage completely resected NSCLC, but that the role of PORT in the treatment of tumors with N2 involvement was unclear, and that further research was warranted. Recent retrospective and non-randomized studies, as well as subgroup analyses of recent randomized trials evaluating adjuvant chemotherapy, provide evidence of the possible benefit of PORT in patients with mediastinal nodal involvement. The role of PORT is also a valid question in patients with proven N2 disease who have undergone only induction chemotherapy followed by surgery, because the local recurrence rate for such patients varies in the range of 20%-60%. Based on the currently available data, PORT should be discussed for fit patients with completely resected NSCLC with N2 nodal involvement, preferably after completion of adju-vant chemotherapy. There is a need for new randomized evidence to evaluate PORT using the modern three-dimensional conformal radiation technique, with attention paid to reducing the risk for, particularly, pulmonary and cardiac toxicity. A new large multi-institutional randomized trial evaluating PORT in this patient population is needed and now under way. The Oncologist 2011;16:672-681

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“…UnfortunateReprint requests should be addressed to J. C. Ruckdeschel * Presented in part at the 16th Annual Meeting of the American Society of Clinical Ontology, San Diego, California, May 27, 1980 ly, the majority of patients have more extensive local spread. Pre-operative [30,33], interstitial [14], postoperative [1,12], and primary radiotherapy [23] have been tested as means of improving the surgical cure rates, with marginal success although palliation of symptoms is often achieved. Chemotherapy as the definitive therapy has shown little promise [16].…”

Section: Introductionmentioning

confidence: 99%

Regional immunotherapy has a detrimental effect on the response to combined irradiation and chemotherapy in locally advanced non-small cell bronchogenic carcinoma

Ruckdeschel

McKneally

Baxter

et al. 1981

Cancer Immunol Immunother

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Postresection Irradiation for Primary Lung Cancer

Cited by 103 publications

References 6 publications

The impact of surgical adjuvant thoracic radiation therapy for patients with nonsmall cell lung carcinoma with ipsilateral mediastinal lymph node involvement

The impact of surgical adjuvant thoracic radiation therapy for patients with nonsmall cell lung carcinoma with ipsilateral mediastinal lymph node involvement

Role of Postoperative Radiotherapy in Resected Non-Small Cell Lung Cancer: A Reassessment Based on New Data

Regional immunotherapy has a detrimental effect on the response to combined irradiation and chemotherapy in locally advanced non-small cell bronchogenic carcinoma

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