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Outcome and prognostic factors of postoperative radiation therapy (PORT) after incomplete resection of non-small cell lung cancer (NSCLC)

Purpose - Current guidelines recommend postoperative radiation therapy (PORT) for incompletely resected non-small cell lung cancer (NSCLC). However, there is still a paucity of evidence for this approach. Hence, we analyzed survival in 78 patients following radiotherapy for incompletely resected NSC...

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Main Authors: Hörner-Rieber, Juliane (Author) , Deeg, Kai Alexander (Author) , Bulut, Elena (Author) , Förster, Robert (Author) , Bischof, Marc (Author) , Warth, Arne (Author) , Schnabel, Philipp A. (Author) , Muley, Thomas (Author) , Kappes, Jutta (Author) , Heußel, Claus Peter (Author) , Welzel, Thomas (Author) , Thomas, Michael (Author) , Steins, Martin (Author) , Dienemann, Hendrik (Author) , Debus, Jürgen (Author) , Hoffmann, Hans (Author) , Rieken, Stefan (Author)
Format: Article (Journal)
Language:English
Published: [2016]
In: Lung cancer
Year: 2016, Volume: 91, Pages: 41-47
ISSN:1872-8332
DOI:10.1016/j.lungcan.2015.11.014
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.lungcan.2015.11.014
Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S0169500215301100
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Author Notes:Juliane Rieber, Alexander Deeg, Elena Ullrich, Robert Foerster, Marc Bischof, Arne Warth, Philipp A. Schnabel, Thomas Muley, Jutta Kappes, Claus Peter Heussel, Thomas Welzel, Michael Thomas, Martin Steins, Hendrik Dienemann, Jürgen Debus, Hans Hoffmann, Stefan Rieken
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Summary:Purpose - Current guidelines recommend postoperative radiation therapy (PORT) for incompletely resected non-small cell lung cancer (NSCLC). However, there is still a paucity of evidence for this approach. Hence, we analyzed survival in 78 patients following radiotherapy for incompletely resected NSCLC (R1) and investigated prognostic factors. - Patients and methods - All 78 patients with incompletely resected NSCLC (R1) received PORT between December 2001 and September 2014. The median total dose for PORT was 60Gy (range 44-68Gy). The majority of patients had locally advanced tumor stages (stage IIA (2.6%), stage IIB (19.2%), stage IIIA (57.7%) and stage IIIB (20.5%)). 21 patients (25%) received postoperative chemotherapy. - Results - Median follow-up after radiotherapy was 17.7 months. Three-year overall (OS), progression-free (PFS), local (LPFS) and distant progression-free survival (DPFS) rates were 34.1, 29.1, 44.9 and 51.9%, respectively. OS was significantly prolonged at lower nodal status (pN0/1) and following dose-escalated PORT with total radiation doses >54Gy (p=0.012, p=0.013). Furthermore, radiation doses >54Gy significantly improved PFS, LPFS and DPFS (p=0.005; p=0.050, p=0.022). Interestingly, survival was neither significantly influenced by R1 localization nor by extent (localized vs. diffuse). Multivariate analyses revealed lower nodal status and radiation doses >54.0Gy as the only independent prognostic factors for OS (p=0.021, p=0.036). - Conclusion - For incompletely resected NSCLC, PORT is used for improving local tumor control. Local progression is still the major pattern of failure. Radiation doses >54Gy seem to support improved local control and were associated with better OS in this retrospective study.
Item Description:Gesehen am 18.06.2020
Physical Description:Online Resource
ISSN:1872-8332
DOI:10.1016/j.lungcan.2015.11.014

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