title: Chemoradiotherapy for locoregional recurrence of non-small-cell lung cancer after surgical resection: a retrospective analysis.
abstract: BACKGROUND
  Even if non-small-cell lung cancer (NSCLC) is diagnosed early and resected, recurrence is common. Uncertainty exists about the optimal treatment of locoregional recurrence. In fit patients with locoregional recurrence, chemoradiotherapy is sometimes offered, but no data exist about the feasibility and efficacy of this approach. We retrospectively collected data from patients treated this way to assess their outcomes and to identify prognostic factors.
  
  
  METHODS
  Databases of The Ottawa Hospital Cancer Centre (TOHCC) (N = 5791) and the Princess Margaret Hospital (PMH) (N = 2225) were screened to identify patients with recurrent NSCLC after curative resection who were offered curative-intent chemoradiotherapy. Selected patients' charts were reviewed.
  
  
  RESULTS
  Thirty patients fit our search criteria. The median disease-free interval was 15 months (2-33 months) and stage at recurrence was mainly T0 (n = 25 [83%]), N2 (n = 25 [83%]), and M0 (n = 29 [97%]). The median radiation dose given at recurrence was 63.5 Gy (26-66 Gy). Chemotherapy included a platinum agent in all cases, mostly a platinum-vinorelbine doublet (n = 14 [47%]), at a median of 3 cycles, (1-6 cycles) 2 of which were concurrent (0-3 cycles). Toxicities were as expected from thoracic chemoradiotherapy, with 7 cases of grade 4 toxicities and no treatment-related deaths. Median follow-up was 22 months (1.5-88 months). Median survival after recurrence was 26.9 months. No prognostic factors were identified.
  
  
  CONCLUSIONS
  Chemoradiotherapy for locoregional recurrent NSCLC is practiced sporadically. This treatment is feasible for highly selected patients, and in our cohort, it allowed for a significantly higher than expected survival. No prognostic factors were identified. Chemoradiotherapy for locoregional NSCLC should be examined in a prospective trial.
authors.affiliation: The Ottawa Hospital Cancer Centre, Ottawa, Canada. bar.jair@gmail.com
authors.forename: Jair
authors.initials: J
authors.lastname: Bar
authors.forename: Dawn
authors.initials: D
authors.lastname: Ng
authors.forename: Patricia
authors.initials: P
authors.lastname: Moretto
authors.forename: Glenwood D
authors.initials: GD
authors.lastname: Goss
authors.forename: Alexander
authors.initials: A
authors.lastname: Sun
authors.forename: Robert
authors.initials: R
authors.lastname: Macrae
authors.forename: Scott A
authors.initials: SA
authors.lastname: Laurie
authors.forename: Natasha
authors.initials: N
authors.lastname: Leighl
authors.forename: Garth
authors.initials: G
authors.lastname: Nicholas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies