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H.W. Lee
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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
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.03-024 - PORT-First Strategy After Surgery in Patients with IIIA-N2 Non-Small Cell Lung Cancer (ID 332)
09:30 - 09:30 | Author(s): H.W. Lee
- Abstract
Background:
Postoperative radiotherapy (PORT) and postoperative chemotherapy (POCT) can be administered as adjuvant therapies in patients with non-small cell lung cancer (NSCLC). The purpose of this study was to investigate the clinical outcomes of the patients treated with PORT-first and following with/without POCT in stage IIIA-N2 NSCLC.
Methods:
From March 1997 to October 2012, 97 patients with stage IIIA-N2 NSCLC who received PORT-first and following with/without POCT were analysed. PORT began within 4-6 weeks after surgical resection, and was delivered using conventional fractionation (1.8 – 2.0 Gy / day) with total dose of 50.4 – 66 Gy. According to the patient’s comorbidity, platinum-based POCT was administered 3 – 4 weeks after completion of PORT. We analysed the outcomes and clinical factors affecting survivals.
Results:
Of 97 patients, 32 (33.0%) received POCT with median of 4 cycles (range, 2 – 6). The follow-up time ranged from 3 to 110 months (median, 24) and 5-year locoregional recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS) were 50.6%, 42.2% and 36.6%. Five-year OS of patients treated with PORT and POCT was significantly higher than that of patients with PORT only (62.9% vs. 28.1%, p = 0.005), and no significant differences in LRRFS (58.9% vs. 47.5%, p = 0.935) and DMFS (52.3% vs. 38.8%, p = 0.541). In multivariate analysis, the significant prognostic factors affecting OS were the use of POCT (HR = 0.44, CI, 0.20 – 0.96, p = 0.039), type of surgery (pneumonectomy/lobectomy, HR = 1.83, CI, 1.01 – 3.35, p = 0.047) and the status of resection margin (positive/negative, HR = 3.20, CI, 1.14 – 8.99, p = 0.027).
Conclusion:
PORT-first strategy after surgery appears not to compromise the clinical outcomes in the treatment of stage IIIA-N2 NSCLC. The additional use of POCT showed improving effect on overall survival even in PORT-first setting.
