The impact of surgical adjuvant thoracic radiation for different stages of non-small cell lung cancer: the experience from a single institution.
A retrospective analysis is performed of 223 patients receiving radiotherapy after complete surgery or microscopic-positive resection margins for non-small cell lung cancer. All patients received a total dose of 55 Gy. For 98 stage II (T1, T2N1), a 5-year survival rate of 37% was found. First failure analysis showed 15% (15/98) local and 39% (38/98) distant failures. Patients with hilar-positive lymph nodes had a 5-year survival rate of 32%, compared with 41% for lobar-positive nodes due to more distant failures. Patients with squamous histology had a better survival than non-squamous tumours. There were 48 patients with pN2 tumours. First failure analysis gave 23% (11/48) local and 39.5% (19/48) distant failures resulting in 35% 5-year survival. Patients with pT3N0 with microscopic-positive resection margins and pT3N1 tumours had 5-year survival rates of 21.5 and 17%. Postoperative radiotherapy should be advised in cases of positive hilar nodes, and in all cases of mediastinal-positive nodes. A combination schedule with chemotherapy seems necessary.
Rodrigus
P
P
Radiation Oncology and Nuclear Medicine, Dr. B. Verbeeten Instituut, LA Tilburg, The Netherlands.
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D017211:Treatment Failure