Author of

• 11673

  +

  P2.09 - Poster Session 2 - Combined Modality (ID 213)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Combined Modality
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11688

    +

    P2.09-015 - Role of postoperative radiotherapy after curative resection and adjuvant chemotherapy for patients with pathological stage N2 non-small cell lung cancer: A propensity score matching analysis (ID 2953)

    09:30 - 09:30  |  Author(s): B.H. Kim
    • Abstract

    Background
    To evaluate the role of postoperative radiotherapy (PORT) after curative resection and adjuvant chemotherapy for patients with pathological stage N2 non-small cell lung cancer (NSCLC).

    Methods
    We performed a retrospective review of 219 consecutive patients who underwent curative surgery followed by adjuvant chemotherapy between 2000 and 2011. Among 219 patients, 41 received PORT additionally. Propensity scores for PORT receipt were calculated for each patient and used for matching to patients without PORT. 118 patients in non-PORT group and 39 patients in PORT group were matched. Clinical and pathologic characteristics were well-balanced after matching. PORT was delivered using conventional technique (n=13) or three-dimensional conformal technique (n=26) with median dose of 54 Gy (range, 50-60). The median follow-up duration for matched patients was 47 months.

    Results
    During the follow-up, 58 patients (49.2%) experienced loco-regional failure in the non-PORT group and 12 patients (30.8%) in the PORT group. Distant metastasis occurred in 68 patients (57.6%) in non-PORT group and 22 patients (56.4%) in PORT group. PORT was associated with improved loco-regional control rate (LRC) (5yr LRC 67.0% vs. 48.4%, p = 0.047), but not disease-free survival (DFS) (5yr DFS 43.3% vs. 32.3%, p = 0.257). An exploratory subgroup analysis suggested a potential DFS benefit of PORT in patients with multiple stations of mediastinal lymph node metastasis (5yr DFS 42.8% vs. 16.6%, p = 0.023). Grade 3 radiation pneumonitis and esophagitis was seen in only one patient, respectively.

    Conclusion
    In pathological stage N2 NSCLC patients, more than half eventually developed distant metastasis despite adjuvant chemotherapy. PORT increased LRC in these propensity-matched patients, but did not DFS. However, patients with multiple stations of mediastinal lymph node metastasis appear to benefit from PORT.