title: Radiation Therapy-First Strategy After Surgery With or Without Adjuvant Chemotherapy in Stage IIIA-N2 Non-Small Cell Lung Cancer.
abstract: OBJECTIVE
  Postoperative radiation therapy (PORT) and postoperative chemotherapy (POCT) can be administered as adjuvant therapies in patients with non-small cell lung cancer (NSCLC). The aim of this study was to present the clinical outcomes in patients treated with PORT-first with or without subsequent POCT in stage IIIA-N2 NSCLC.
  
  
  METHODS
  From January 2002 to November 2014, the conditions of 105 patients with stage IIIA-N2 NSCLC who received PORT-first with or without subsequent POCT were analyzed. PORT was initiated within 4 to 6 weeks after surgical resection. Platinum-based POCT was administered 3 to 4 weeks after the completion of PORT. We analyzed the outcomes and the clinical factors affecting survival.
  
  
  RESULTS
  Of 105 patients, 43 (41.0%) received POCT with a median of 4 cycles (range, 2-6 cycles). The follow-up times ranged from 3 to 123 months (median, 30 months), and the 5-year overall survival (OS) was 40.2%. The 5-year OS of patients treated with PORT and POCT was significantly higher than that of patients with PORT (61.3% vs 29.2%, P<.001). The significant prognostic factors affecting OS were the use of POCT (hazard ratio [HR] = 0.453, P=.036) and type of surgery (pneumonectomy/lobectomy; HR = 2.845, P<.001).
  
  
  CONCLUSIONS
  PORT-first strategy after surgery appeared not to compromise the clinical outcomes in the treatment of stage IIIA-N2 NSCLC. The benefit of POCT on OS was preserved even in the PORT-first setting. Further studies are warranted to compare the sequencing of PORT and POCT, guaranteeing the proper use of POCT.
authors: Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Hyun Woo
authors: HW
authors: Lee
authors: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: okyu.noh@gmail.com.
authors: O Kyu
authors: OK
authors: Noh
authors: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Young-Taek
authors: YT
authors: Oh
authors: Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Jin-Hyuk
authors: JH
authors: Choi
authors: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Mison
authors: M
authors: Chun
authors: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Hwan-Ik
authors: HI
authors: Kim
authors: Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Jaesung
authors: J
authors: Heo
authors: Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Mi Sun
authors: MS
authors: Ahn
authors: Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Seong Yong
authors: SY
authors: Park
authors: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Rae Woong
authors: RW
authors: Park
authors: Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea.
authors: Dukyong
authors: D
authors: Yoon
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D018714:Radiotherapy, Adjuvant / Q000401:mortality; D020266:Radiotherapy, Conformal; D013997:Time Factors; D016896:Treatment Outcome