scholarly journals Reappraisal of the role of postoperative radiation therapy in patients with pIIIa-N2 non-small cell lung cancer: A propensity score matching analysis

2015 ◽  
Vol 6 (5) ◽  
pp. 570-578 ◽  
Author(s):  
Qinchen Cao ◽  
Baozhong Zhang ◽  
Lujun Zhao ◽  
Changli Wang ◽  
Liqun Gong ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Propensity Score ◽  
Small Cell Lung Cancer ◽  
Small Cell ◽  
Postoperative Radiation ◽  
Small Cell Lung ◽  
Postoperative Radiation Therapy ◽  
Propensity Score Matching Analysis

scholarly journals The Role of Postoperative Radiation Therapy for pN2 Non–small-cell Lung Cancer

2021 ◽  
Vol 22 (1) ◽  
pp. e5-e17
Author(s):  
Nikhil P. Mankuzhy ◽  
Muayad F. Almahariq ◽  
Zaid A. Siddiqui ◽  
Andrew B. Thompson ◽  
Inga S. Grills ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Postoperative Radiation ◽  
Small Cell Lung ◽  
Postoperative Radiation Therapy

Indications and Parameters Around Postoperative Radiation Therapy for Lung Cancer

2022 ◽  
Author(s):  
Antonin Levy ◽  
Olaf Mercier ◽  
Cécile Le Péchoux
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
High Risk ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Small Cell ◽  
Postoperative Radiation ◽  
Small Cell Lung ◽  
Postoperative Radiation Therapy

Patients with locally advanced resected non–small-cell lung cancer present a high risk of relapse. Although adjuvant platinum–based chemotherapy has become the standard of care, the role of postoperative radiation therapy (PORT) has been controversial for years. In patients with incomplete resection, PORT should be proposed, on the basis of a strong consensus, despite the absence of randomized evidence. In patients with completely resected (R0) non–small-cell lung cancer, a meta-analysis showed poorer outcomes after PORT in the absence of mediastinal involvement (pN0 and pN1). In patients with pN2, the role of PORT was less clear and required further research. The meta-analysis included trials using older radiation techniques and poorer quality of surgery according to today's standards, and selection of patients was not positron emission tomography–based. Newer retrospective and nonrandomized studies and subgroup analyses of randomized trials evaluating adjuvant chemotherapy suggested a survival benefit of PORT in patients with pN2 R0. Two recent randomized trials (Lung ART and PORT-C) evaluating conformal PORT versus no PORT retrieved no disease-free survival advantage for stage IIIA-N2 patients, even if mediastinal relapse was significantly decreased with PORT. PORT had no effect on survival, possibly given the high rate of distant relapse and risk of additional cardiopulmonary toxicity. Ongoing and future analyses are planned in Lung ART to identify patients for whom PORT could be recommended. Incorporation of newer systemic treatments (immune checkpoint inhibitors or targeted therapy in oncogene-addicted patients) is underway in the neoadjuvant and/or adjuvant setting. Better identification of patients at a high risk of disease recurrence, with analysis of circulating tumor DNA, on the basis of the detection of postsurgical minimal (or molecular) residual disease is warranted in future studies.

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