Stage III-pN2 NSCLC: add postoperative RT to boost survival

  • Wei W & al.
  • Cancer Med
  • 26 Feb 2020

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • The receipt of postoperative radiotherapy (PORT) is associated with significantly better local recurrence-free survival (LRFS) and OS in patients with stage III-pN2 NSCLC.

Why this matters

  • These findings suggest better survival with PORT than reported in a previous meta-analysis, likely because of improved RT techniques that have decreased risk for cardiac and pulmonary toxicity.

Study design

  • 183 patients with resected stage III-pN2 NSCLC received postoperative chemotherapy and radiotherapy (POCRT; n=78) or postoperative chemotherapy (POCT; n=105).
  • Funding: Hunan Youth Talent Project and Fundamental Research Funds for the Central Universities.

Key results

  • Median and 2-year LRFS were significantly higher with POCRT vs POCT:
    • 29 vs 17 months.
    • 62.1% vs 35.1% (P<.001>
  • Median and 2-year OS were significantly better with POCRT vs POCT:
    • 34 vs 29 months.
    • 78.3% vs 62.1% (P=.008).
  • By pN2 subclassification, patients with multiple-station pN2±pN1 disease had the worst LRFS, and patients in the POCRT group had better LRFS (11 months in POCT vs 27 months in POCRT).
  • Receipt of PORT was significantly associated with better LRFS:
    • Adjusted HR, 0.499; P<.001>

Limitations

  • Single-center, retrospective study.