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http://hdl.handle.net/1942/23908
Title: | Postoperative radiotherapy in stage III non-small cell lung cancer: Is a reassessment necessary in modern times? | Authors: | BILLIET, Charlotte | Advisors: | MEBIS, Jeroen De Ruysscher, Dirk |
Issue Date: | 2017 | Abstract: | Background: 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 R0) 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 highrisk 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. | Document URI: | http://hdl.handle.net/1942/23908 | Category: | T1 | Type: | Theses and Dissertations |
Appears in Collections: | PhD theses Research publications |
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Doctoraal proefschrift C.Billiet definitief.pdf Restricted Access | 3.11 MB | Adobe PDF | View/Open Request a copy |
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