[Postoperative radiotherapy in lung cancer: comments on several randomized trials or the contribution of well-conducted radiotherapy].
Postoperative radiotherapy is classically proposed after surgical resection in case of a high risk of local recurrence (incomplete resection and nodal invasion especially mediastinal). Its interest was shown by non-randomized trials. Nevertheless, several randomized trials and one meta-analysis of them have recently questioned the contribution of radiotherapy. We analyze here these trials then the meta-analysis, emphasizing certain methodology problems such as the noninclusion of certain therapeutic trials and differences in radiotherapy dosages and techniques. In our opinion, excessive toxicity observed in certain trials can be attributed to technical errors; if well conducted, postoperative radiotherapy improves survival in operated patients when there is a high risk of local reccurence. This affirmation is based on a comparison of long term results of 347 non randomized cases with Port Meta-Analysis randomized cases and GETCB trial randomized cases.
Baillet
F
F
Service de Radiothérapie-Cancérologie, Groupe Hospitalier Pitié-Salpêtrière, 47 Bd de l'Hôpital, 75651 Paris Cedex 13.
D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D008207:Lymphatic Metastasis; D015201:Meta-Analysis as Topic; D009364:Neoplasm Recurrence, Local; D011013:Pneumonectomy; D011184:Postoperative Period; D011879:Radiotherapy Dosage; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013997:Time Factors