Post-operative radiotherapy in N2 non-small cell lung cancer: a retrospective analysis of 175 patients.
OBJECTIVE
Post-operative radiotherapy (PORT) in radically resected non-small cell lung cancer (NSCLC) has the aim to reduce loco regional recurrence and to improve overall survival. PORT has been evaluated in several trials but indication to post-operative treatment in N2 patients is still debated.


METHODS
We retrospectively analyzed 175 patients treated at University of Florence between 1988 and 2004 with completely resected NSCLC stages IIIA-IIIB, N2 disease. Surgery consisted in a lobectomy in 58.9% and in a bi-lobectomy or in a pneumonectomy in 41.1% of patients. One hundred and nineteen patients underwent PORT and 56 patients did not receive PORT (no-PORT).


RESULTS
At a median follow-up of 27.6 months (range 4-233 months), we found a significant reduction in local recurrence (LR) in PORT group (log-rank test p=0.015; HR: 0.45; 95%CI: 0.24-0.87). No statistical difference were found in terms of overall survival (OS) (log-rank test p=0.92). Concerning other prognostic factors, male sex emerged as statistically significant (HR:4.33;1.04-18.02) on local progression free survival (LPFS) at univariate analysis. Acute and long-term toxicity was mild.


CONCLUSIONS
Our retrospective analysis showed that PORT may improve local disease control in N2 NSCLC patients with an acceptable treatment-related toxicity.
Scotti
Vieri
V
Department of Radiation-Oncology, University of Florence, Italy. v.scotti@dfc.unifi.it
Meattini
Icro
I
Saieva
Calogero
C
Agresti
Benedetta
B
de Luca Cardillo
Carla
C
Bastiani
Paolo
P
Livi
Lorenzo
L
Mangoni
Monica
M
Di Cataldo
Vanessa
V
Marrazzo
Livia
L
Rampini
Andrea
A
Cipressi
Samantha
S
Bruni
Alessio
A
Santini
Paolo
P
Biti
Giampaolo
G
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D016016:Proportional Hazards Models; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012016:Reference Values; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome