title: Concurrent paclitaxel-based chemo-radiotherapy for post-surgical microscopic residual tumor at the bronchial margin (R1 resection) in non-small-cell lung cancer.
abstract: BACKGROUND
  The microscopic residual tumor at the bronchial margin after radical surgery (R1 resection) affects prognosis negatively in non-small-cell lung cancer (NSCLC) patients. For patients with good performance status, a potential cure still exists. Here, we report the outcomes of concurrent paclitaxel-based chemo-radiotherapy (CRT) for NSCLC patients with microscopically positive bronchial margins or peribronchial infiltration.
  
  
  METHODS
  A retrospective search in the clinical database was conducted in three hospitals. Patients were identified and evaluated if treated with radiotherapy combined with paclitaxel-based chemotherapy. The objects analyzed were local control time, progression-free survival (PFS), overall survival (OS), and treatment-related toxicity.
  
  
  RESULTS
  Sixty-one patients with microscopic residual tumor at the bronchial stump following pulmonary lobectomy were identified. Forty-six patients who had received concurrent paclitaxel-based CRT were analyzed. The median follow-up was 40 months (range: 15.0-77.5 months). The 1-, 2- and 3-year survival rates were 97.8%, 60.9% and 36.9%, respectively. The local recurrences were recorded in 19.6% (9/46) patients. Median PFS and OS for the evaluated cohort were 23.0 [95% confidence interval (CI): 21.3-24.7] and 32.0 (95% CI: 23.7-40.3) months, respectively. The most common side effects were hematological toxicity (neutropenia, 93.5%; anemia, 89.1%; and thrombocytopenia, 89.1%) and no treatment-related deaths. Grade ≥2 acute radiation-induced pneumonitis and esophagitis were recorded in 43.5% (20/46) and 26.1% (12/46) patients, respectively. By univariate analysis, non-squamous cell lung cancer was associated with a significantly longer survival time (45.1 vs 26.4 months, p = 0.013).
  
  
  CONCLUSIONS
  For NSCLC patients with post-surgical microscopic residual tumor at the bronchial stump, concurrent paclitaxel-based chemo-radiotherapy achieved promising outcomes with accepted treatment-related toxicity.
authors: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. 395261330@qq.com.
authors: Meixiang
authors: M
authors: Zhou
authors: Radiation Physics Center, Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. litao1315@sina.com.
authors: Tao
authors: T
authors: Li
authors: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. lymi75@163.com.
authors: Yongmei
authors: Y
authors: Liu
authors: Department of Radiation Oncology, Second People's Hospital of Sichuan, Chengdu, 610031, PR.China. cjsun@163.com.
authors: Changjin
authors: C
authors: Sun
authors: Department of Oncology, Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, PR. China. lina_anhuimu@163.com.
authors: Na
authors: N
authors: Li
authors: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. xy868996@163.com.
authors: Yong
authors: Y
authors: Xu
authors: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. zhujiang1@medmail.com.cn.
authors: Jiang
authors: J
authors: Zhu
authors: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. dingzy333@163.com.
authors: Zhenyu
authors: Z
authors: Ding
authors: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. wangys@scu.edu.cn.
authors: Yongsheng
authors: Y
authors: Wang
authors: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. hmj107@163.com.
authors: Meijuan
authors: M
authors: Huang
authors: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. pfwork@126.com.
authors: Feng
authors: F
authors: Peng
authors: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. wangjin_hxyy@scu.edu.cn.
authors: Jin
authors: J
authors: Wang
authors: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. renlihx@163.com.
authors: Li
authors: L
authors: Ren
authors: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. radyoulu@hotmail.com.
authors: You
authors: Y
authors: Lu
authors: Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, PR. China. gongyouling@hotmail.com.
authors: Youling
authors: Y
authors: Gong
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000473:pathology* / Q000628:therapy*; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology*; D011182:Postoperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome
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