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Y. Xu



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    P2.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 213)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Locoregional Disease – NSCLC
    • Presentations: 1
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      P2.03-012 - Neoadjuvant Chemoradiotherapy or Chemotherapy Followed by Surgery Is Superior to That Definitive Chemoradiation in Stage IIIA (N2) NSCLC (ID 2628)

      09:30 - 09:30  |  Author(s): Y. Xu

      • Abstract
      • Slides

      Background:
      Whether neoadjuvant chemoradiotherapy or chemotherapysurgery followed by surgery is superior to that followed by definitive radiotherapy in Stage IIIA (N2) NSCLC remains controversial.

      Methods:
      A literature search was performed in the Pubmed, Embase, Medline database (last search updated in March 2015) and a systematic review and meta-analysis of available data was conducted.

      Results:
      A total of nine studies including five randomized controlled trials and four retrospective studies were enrolled in this meta-analysis. A significant homogeneity (χ2=49.62 ,p=0.000，I[2]=81.9% ) between the four studies with a total of 11948 selected cases was detected between the nine studied investigated overall survival (OS), the random effects model was used to conduct meta-analysis. The combined hazard ratio (HR) of for was 0.65 (95% confidence interval [CI]: 0.60-0.71; p=0.000). Subgroup analysis was investigated according to study design and extent of resection. We observed a statistically significantly better outcome after lobectomy (combined HR: 0.52; 95% CI: 0.47-0.58; p =0.000) than after pneumonectomy (combined HR: 0.82; 95% CI: 0.69–0.98; p=0. 028). Unfortunately, there was no significant difference in randomized controlled studies for the combined HR was 0.94 (95% CI: 0.81-1.09; p = 0. 440).

      Conclusion:
      Neoadjuvant chemoradiotherapy or chemotherapy followed by surgery is superior to that followed by definitive radiotherapy, particularly in patients with lobectomy. Further study to investigate randomized trial be performed comparing chemoradiation followed by lobectomy vs. definitive chemoradiation in patients with stage IIIA disease is urgently needed.

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