Comparison of Radiotherapy and Chemoradiotherapy for Locoregional Recurrence of Non–small-cell Lung Cancer Developing After Surgery

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Abstract

Background

The optimal treatment strategy for locoregional recurrences developing after surgical resection in patients with non–small-cell lung cancer (NSCLC) is yet to be clearly established.

Patients and Methods

To investigate the efficacy and safety of radiotherapy (RT) and chemoradiotherapy (CRT), we reviewed the consecutive data of patients with NSCLC with postoperative locoregional recurrences treated at the National Cancer Center Hospital between January 2000 and April 2010.

Results

We reviewed the data of 74 patients (including 56 who received RT alone and 18 who received CRT) according to our study criteria. The median age was lower and the N factor at the recurrence site was higher in the CRT group compared with the RT group. Most patients received 60 Gy/30 Fr RT in both groups. The 2-year progression-free survival (PFS) rate, median PFS, and overall survival (OS) were 44.4%, 19.0 months (95% confidence interval [CI], 0-41.9 months), and 79.6 months (95% CI, 8.2-151.0 months), respectively, in the CRT group, although those were 25.0%, 10.6 months (95% CI, 8.7-12.9 months), and 33.1 months (95% CI, 17.9-48.3 months), respectively, in the RT group. The adverse event profile was acceptable, with no treatment-related death in either group. Multivariate analysis identified CRT as being significantly associated with a longer PFS and OS.

Conclusion

CRT tended to yield better results than RT in terms of the survival outcomes, with acceptable safety profiles of both. We consider that a randomized study comparing RT and CRT is warranted to identify the optimal treatment strategy for patients with NSCLC with postoperative locoregional recurrences.

Micro-Abstract

There is little evidence on treatment strategy for postoperative locoregional relapsed non–small-cell lung cancer. Seventy-four consecutive patients with non–small-cell lung cancer with postoperative locoregional recurrences who received chemoradiotherapy (CRT) or radiotherapy at our institute were analyzed. Multivariate analysis identified CRT as a significant survival factor. CRT showed favorable survival outcomes with acceptable feasibility of both CRT and radiotherapy.

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