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Title: | Postoperative radiotherapy for lung cancer: Is it worth the controversy? | Authors: | BILLIET, Charlotte Peeters, Stephanie Decaluwe, Herbert Vansteenkiste, Johan MEBIS, Jeroen De Ruysscher, Dirk |
Issue Date: | 2016 | Publisher: | ELSEVIER SCI LTD | Source: | CANCER TREATMENT REVIEWS, 51, p. 10-18 | Abstract: | Introduction: The role of postoperative radiation therapy (PORT) in patients with completely resected non-small cell lung cancer (NSCLC) with pathologically involved mediastinal lymph nodes (N2) remains unclear. Despite a reduction of local recurrence (LR), its effect on overall survival (OS) remains unproven. Therefore we conducted a review of the current literature. Methods: To investigate the benefit and safety of modern PORT, we identified published phase III trials for PORT. We investigated modern PORT in low-risk (ypN0/1 and RO) and high-risk (ypN2 and/or R1/2) patients with stage III-N2 NSCLC treated with induction chemotherapy and resection. Results: Seventeen phase III trials using PORT were selected. Of all PORT N2 studies, 4 were eligible for evaluation of LR, all in high-risk patients only. In these high-risk patients receiving PORT, the mean LR rate at 5 years was 20.9% (95% CI 16-24). Two trials were suitable to assess LR rates after chemotherapy and surgery without PORT. In these low-risk patients, the mean 5-year LR was 33.1% (95% CI 27-39). No significant difference in non-cancer deaths between PORT vs. non-PORT patients was observed in N2 NSCLC. Conclusion: PORT is worth the controversy because data illustrate that PORT may increase the OS. However, prospective randomized trials are needed to verify this. (C) 2016 Elsevier Ltd. All rights reserved. | Notes: | [Billiet, Charlotte; Peeters, Stephanie; De Ruysscher, Dirk] Katholieke Univ Leuven, Univ Leuven, Dept Radiat Oncol, B-3000 Louvain, Belgium. [Billiet, Charlotte; Mebis, Jeroen] Hasselt Univ, Fac Med & Life Sci, Martelarenlaan 42, B-3500 Hasselt, Belgium. [Decaluwe, Herbert] Katholieke Univ Leuven, Univ Leuven, Dept Thorac Surg, B-3000 Louvain, Belgium. [Decaluwe, Herbert; Vansteenkiste, Johan] Leuven Lung Canc Grp, B-3000 Louvain, Belgium. [Vansteenkiste, Johan] Katholieke Univ Leuven, Univ Leuven, Dept Pneumol, Resp Oncol Unit, B-3000 Louvain, Belgium. [Mebis, Jeroen] Jessa Hosp, Dept Med Oncol, B-3500 Hasselt, Belgium. [De Ruysscher, Dirk] Maastricht Univ, Med Ctr, GROW, Dept Radiat Oncol MAASTRO, Maastricht, Netherlands. | Keywords: | post-operative radiotherapy; non-small-cell lung cancer; review;Post-operative radiotherapy; Non-small-cell lung cancer; Review | Document URI: | http://hdl.handle.net/1942/23068 | ISSN: | 0305-7372 | e-ISSN: | 1532-1967 | DOI: | 10.1016/j.ctrv.2016.10.001 | ISI #: | 000389293900002 | Rights: | (C) 2016 Elsevier Ltd. All rights reserved. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2018 |
Appears in Collections: | PhD theses Research publications |
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File | Description | Size | Format | |
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billiet 1.pdf Restricted Access | Published version | 654.21 kB | Adobe PDF | View/Open Request a copy |
postoperative author.pdf | Peer-reviewed author version | 872.22 kB | Adobe PDF | View/Open |
Tables.pdf | Supplementary material | 717.71 kB | Adobe PDF | View/Open |
SI.pdf | Supplementary material | 292.26 kB | Adobe PDF | View/Open |
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