PV QA 4 - Poster Viewing Q&A 4
Purpose/Objective(s): 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.
Materials/Methods: From Jan. 2003 to Dec. 2015, consecutive patients with resected pathological stage IIIA–N2 NSCLC at our institution were retrospectively analyzed in an institutional review board–approved study. The effect of PORT on OS and disease-free survival (DFS) was evaluated using the Kaplan–Meier method and log-rank tests. The impact of PORT on locoregional control and distant metastasis was also analyzed. Cox’s proportional hazards model was used for multivariate analysis. A statistically significant difference was set as p＜0.05.
Results: Totally 1434 patients were enrolled, including 341 (23.8%) in the PORT group and 1093 (76.2%) in the non-PORT group. The median follow-up time was 28.8 months. Patients treated with PORT had significantly longer median OS (85.5 vs 56.1 months, p=0.000) and DFS (24.2 vs 19.1 months, p=0.001) when compared with the control. The 3- and 5-year OS rates were72.1% and 60.6%, respectively in the PORT group and were 62.9%, and 48.0%, respectively in the non-PORT group. The 3- and 5-year DFS rates were 41.4%, and 34.5%, respectively in the PORT group and were 33.8%, and 23.2%, respectively in the non-PORT group. Patients treated with PORT also had a significantly higher locoregional recurrence-free survival rate (LRFS) as well as distant metastasis-free survival rate (DMFS). The 3- and 5-year LRFS rates were 60.5%, and 50.0% in the PORT group and 48.2%, and 35.5% in the non-PORT group (p=0.000), respectively. The 3- and 5-year DMFS rates were 46.2%, and 38.3% in the PORT group and 40.9%, and 27.9% in the non-PORT group, respectively (p=0.015). Multivariate analyses showed that PORT was an independent prognostic factor associating with better OS (p=0.010).
Conclusion: For patients with resected pathological stage IIIA–N2 NSCLC, PORT can significantly improve the rates of OS, DFS, LRFS and DMFS. A prospective randomized multicenter clinical trial led by our institution is ongoing now.
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