Selection of proper candidates with resected pathological stage IIIA‐N2 non‐small cell lung cancer for postoperative radiotherapy

Thoracic Cancer

Zhouguang Hui¹  Honghai Dai¹  Jun Liang¹  Jima Lv¹  Zongmei Zhou¹  Qinfu Feng¹  Zefen Xiao¹  Dongfu Chen¹  Hongxing Zhang¹  Weibo Yin¹ 

[1] Department of Radiation Oncology, Cancer Institute & Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China

关键词: IIIA‐N2;    non‐small‐cell lung cancer;    postoperative radiotherapy;    prediction model;    surgery;   

DOI  :  10.1111/1759-7714.12186

来源: Wiley

【 摘 要 】

Abstract

Background

To establish a prediction model in selecting fit patients with resected pIIIA-N2 non-small cell lung cancer (NSCLC) for postoperative radiotherapy (PORT), and evaluate the model in clinical practice.

Methods

Between January 2003 and December 2005, 221 patients with resected pIIIA-N2 NSCLC were retrospectively analyzed. The effect of PORT on overall survival (OS) of patients with different clinicopathological factors was evaluated and the results were used to establish a prediction model to select patients fit for PORT.

Results

Compared with the control, PORT significantly improved the OS of patients with a smoking index ≤400 (P = 0.033), cN2 (P = 0.003), pT3 (P = 0.014), squamous cell carcinoma (SCC) (P = 0.013), or ≥4 positive nodes (P = 0.025). Patients were divided from zero to all five factors into low, middle, and high PORT index (PORT-I) groups (scored 0–1, 2, and 3–5, respectively). PORT did not improve OS (3-year, P = 0.531), disease free survival (DFS) (P = 0.358), or loco-regional recurrence free survival (LRFS) (P = 0.412) in the low PORT-I group. PORT significantly improved OS (P = 0.033), and tended to improve DFS (P = 0.064), but not LRFS (P = 0.287) in the middle PORT-I group. PORT could significantly improve OS (P = 0.000), DFS (P = 0.000), and LRFS (P = 0.006) in the high PORT-I group.

Conclusion

The prediction model is valuable in selecting patients with resected pIIIA-N2 NSCLC fit for PORT. PORT is strongly recommended for patients with three or more of the five factors of smoking index ≤400, cN2, pT3, SCC, and ≥4 positive nodes.

【 授权许可】

CC BY-NC   
© 2014 The Authors. Thoracic Cancer published by Tianjin Lung Cancer Institute and Wiley Publishing Asia Pty Ltd.

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