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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/23068

Title: Postoperative radiotherapy for lung cancer: Is it worth the controversy?
Authors: Billiet, Charlotte
Peeters, Stephanie
Decaluwe, Herbert
Vansteenkiste, Johan
Mebis, Jeroen
De Ruysscher, Dirk
Issue Date: 2016
Publisher: ELSEVIER SCI LTD
Citation: CANCER TREATMENT REVIEWS, 51, p. 10-18
Abstract: Introduction: The role of postoperative radiation therapy (PORT) in patients with completely resected non-small cell lung cancer (NSCLC) with pathologically involved mediastinal lymph nodes (N2) remains unclear. Despite a reduction of local recurrence (LR), its effect on overall survival (OS) remains unproven. Therefore we conducted a review of the current literature. Methods: To investigate the benefit and safety of modern PORT, we identified published phase III trials for PORT. We investigated modern PORT in low-risk (ypN0/1 and RO) and high-risk (ypN2 and/or R1/2) patients with stage III-N2 NSCLC treated with induction chemotherapy and resection. Results: Seventeen phase III trials using PORT were selected. Of all PORT N2 studies, 4 were eligible for evaluation of LR, all in high-risk patients only. In these high-risk patients receiving PORT, the mean LR rate at 5 years was 20.9% (95% CI 16-24). Two trials were suitable to assess LR rates after chemotherapy and surgery without PORT. In these low-risk patients, the mean 5-year LR was 33.1% (95% CI 27-39). No significant difference in non-cancer deaths between PORT vs. non-PORT patients was observed in N2 NSCLC. Conclusion: PORT is worth the controversy because data illustrate that PORT may increase the OS. However, prospective randomized trials are needed to verify this. (C) 2016 Elsevier Ltd. All rights reserved.
Notes: [Billiet, Charlotte; Peeters, Stephanie; De Ruysscher, Dirk] Katholieke Univ Leuven, Univ Leuven, Dept Radiat Oncol, B-3000 Louvain, Belgium. [Billiet, Charlotte; Mebis, Jeroen] Hasselt Univ, Fac Med & Life Sci, Martelarenlaan 42, B-3500 Hasselt, Belgium. [Decaluwe, Herbert] Katholieke Univ Leuven, Univ Leuven, Dept Thorac Surg, B-3000 Louvain, Belgium. [Decaluwe, Herbert; Vansteenkiste, Johan] Leuven Lung Canc Grp, B-3000 Louvain, Belgium. [Vansteenkiste, Johan] Katholieke Univ Leuven, Univ Leuven, Dept Pneumol, Resp Oncol Unit, B-3000 Louvain, Belgium. [Mebis, Jeroen] Jessa Hosp, Dept Med Oncol, B-3500 Hasselt, Belgium. [De Ruysscher, Dirk] Maastricht Univ, Med Ctr, GROW, Dept Radiat Oncol MAASTRO, Maastricht, Netherlands.
URI: http://hdl.handle.net/1942/23068
DOI: 10.1016/j.ctrv.2016.10.001
ISI #: 000389293900002
ISSN: 0305-7372
Category: A1
Type: Journal Contribution
Appears in Collections: PhD theses
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