Radiat Oncol J.  2014 Sep;32(3):147-155. 10.3857/roj.2014.32.3.147.

The single institutional outcome of postoperative radiotherapy and concurrent chemoradiotherapy in resected non-small cell lung cancer

• Lee HC
• Kim YS
• Oh SJ
• Lee YH
• Lee DS
• Song JH
• Kang JH
• Park JK

• KMID: 2316729
• DOI: http://doi.org/10.3857/roj.2014.32.3.147

Abstract

PURPOSE
This study was conducted to observe the outcomes of postoperative radiotherapy (PORT) with or without concurrent chemotherapy in resected non-small cell lung cancer (NSCLC) in single institution.
MATERIALS AND METHODS
From 2002 to 2013, 78 patients diagnosed with NSCLC after curative resection were treated with radiotherapy alone (RT, n = 48) or concurrent chemoradiation (CCRT, n = 30). The indications of adjuvant radiation therapy were N2 node positive (n = 31), close or involved resection margin (n = 28), or gross residual disease due to incomplete resection (n = 19). The median radiation dose was 57.6 Gy (range, 29.9 to 66 Gy).
RESULTS
Median survival time was 33.7 months (range, 4.4 to 140.3 months). The 5-year overall survival (OS) rate was 49.5% (RT 46% vs. CCRT 55.2%; p = 0.731). The 3-year disease-free survival rate was 45.5% (RT 39.4% vs. CCRT 55.3%; p = 0.130). The 3-year local control rate was 68.1% (RT 64.4% vs. CCRT 77.7%; p = 0.165). The 3-year DMFS rate was 56.1% (RT 52.6% vs. CCRT 61.7%; p = 0.314). In multivariate analysis, age > or =66 years and pathologic stage III were significant poor prognostic factors for OS. Treatment failure occurred in 40 patients. Four patients had radiologically confirmed grade 3 radiation pneumonitis.
CONCLUSION
In NSCLC, adjuvant RT or CCRT after curative surgery is a safe and feasible modality of treatment. OS gain was seen in patients less than 66 years. Postoperative CCRT showed a propensity of achieving better local control and improved disease-free survival compared to RT alone according to our data.

Keyword

Non-small-cell lung carcinoma; Radiotherapy; Chemoradiotherapy

MeSH Terms

Carcinoma, Non-Small-Cell Lung*
Chemoradiotherapy*
Disease-Free Survival
Drug Therapy
Humans
Multivariate Analysis
Radiation Pneumonitis
Radiotherapy*
Treatment Failure