Role of Adjuvant Thoracic Radiation Therapy and Full Dose Chemotherapy in pN2 Non-small Cell Lung Cancer: Elucidation Based on Single Institute Experience
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Purpose The optimal adjuvant therapy modality for treating pN2 non-small cell lung cancer patients has not yet been established. In this study, the authors investigated clinical outcomes following three different adjuvant therapy modalities. Materials and Methods From January 2006 to December 2012, 240 patients with cN0/1 disease were found to have pN2 disease following curative resection and received one of three adjuvant therapy modalities: thoracic radiation therapy (TRT) and concurrent chemotherapy (CTx) (CCRT) (group I), CCRT plus consolidation CTx (group II), and CTx alone (group III). TRT was delivered to 155 patients (groups I/II), and full dose CTx was delivered to 172 patients either as a consolidative or a sole modality (group II/III). Results During 30 months of median follow-up, 44 patients died and 141 developed recurrence. The 5-year overall survival (OS), locoregional control (LRC), distant metastasis-free survival (DMFS), and disease-free survival (DFS) rates of all patients were 76.2%, 80.7%, 36.4%, and 29.6%, respectively. There was no difference in OS among groups. TRT (groups I/II) significantly improved LRC, full dose CTx (groups II/III) did DMFS, and CCRT plus consolidation CTx (group II) did DFS, respectively. Conclusion The current study could support that TRT could improve LRC and full dose CTx could improve DMFS and that CCRT plus consolidation CTx could improve DFS.
Abstract
Purpose The optimal adjuvant therapy modality for treating pN2 non-small cell lung cancer patients has not yet been established. In this study, the authors investigated clinical outcomes following three different adjuvant therapy modalities. Materials and Methods From January 2006 to December 2012, 240 patients with cN0/1 disease were found to have pN2 disease following curative resection and received one of three adjuvant therapy modalities: thoracic radiation therapy (TRT) and concurrent chemotherapy (CTx) (CCRT) (group I), CCRT plus consolidation CTx (group II), and CTx alone (group III). TRT was delivered to 155 patients (groups I/II), and full dose CTx was delivered to 172 patients either as a consolidative or a sole modality (group II/III). Results During 30 months of median follow-up, 44 patients died and 141 developed recurrence. The 5-year overall survival (OS), locoregional control (LRC), distant metastasis-free survival (DMFS), and disease-free survival (DFS) rates of all patients were 76.2%, 80.7%, 36.4%, and 29.6%, respectively. There was no difference in OS among groups. TRT (groups I/II) significantly improved LRC, full dose CTx (groups II/III) did DMFS, and CCRT plus consolidation CTx (group II) did DFS, respectively. Conclusion The current study could support that TRT could improve LRC and full dose CTx could improve DMFS and that CCRT plus consolidation CTx could improve DFS.
참고문헌 (21)
- The Lung Cancer Study Group, "Effects of postoperative mediastinal radiation on completely resected stage II and stage III epidermoid cancer of the lung", N Engl J Med, 315, pp.1377~1381 (1986)
- Stephens RJ, "The role of post-operative radiotherapy in nonsmall-cell lung cancer: a multicentre randomised trial in patients with pathologically staged T1-2, N1-2, M0 disease. Medical Research Council Lung Cancer Working Party", Br J Cancer, 74, pp.632~639 (1996)
- Feng QF, "A study of postoperative radiotherapy in patients with non-small-cell lung cancer : a randomized trial", Int J Radiat Oncol Biol Phys, 47, pp.925~929 (2000)
- Pignon JP, "Lung adjuvant cisplatin evaluation : a pooled analysis by the LACE Collaborative Group", J Clin Oncol, 26, pp.3552~3559 (2008)
- NSCLC Meta-analyses Collaborative Group, "Adjuvant chemotherapy, with or without postoperative radiotherapy, in operable non-small-cell lung cancer : two meta-analyses of individual patient data", Lancet, 375, pp.1267~1277 (2010)
- Willers H, "ACR Appropriateness Criteria((R))induction and adjuvant therapy for N2 non-small-cell lung cancer", Am J Clin Oncol, 38, pp.197~205 (2015)
- PORT Meta-analysis Trialists Group, "Postoperative radiotherapy for non-small cell lung cancer", Cochrane Database Syst Rev, (2), pp.CD002142~ (2005)
- Billiet C, "Modern post-operative radiotherapy for stage III non-small cell lung cancer may improve local control and survival : a meta-analysis", Radiother Oncol, 110, pp.3~8 (2014)
- Bradley JD, "Phase II trial of postoperative adjuvant paclitaxel", carboplatin and thoracic radiotherapy in resected stage II and IIIA non-small-cell lung cancer : promising longterm results of the Radiation Therapy Oncology Group : RTOG 9705, 2005, pp.23, 3480~3487
- Feigenberg SJ, "A phase II study of concurrent carboplatin and paclitaxel and thoracic radiotherapy for completely resected stage II and IIIA non-small cell lung cancer", J Thorac Oncol, 2, pp.287~292 (2007)
- Shen WY, "Comparison of efficacy for postoperative chemotherapy and concurrent radiochemotherapy in patients with IIIA-pN2 non-small cell lung cancer : an early closed randomized controlled trial", Radiother Oncol, 110, pp.120~125 (2014)
- 이효전, "The single institutional outcome of postoperative radiotherapy and concurrent chemoradiotherapy in resected non-small cell lung cancer", Radiation oncology journal, 32(3), pp.147~155 (2014), 대한방사선종양학회
- Keller SM, "A randomized trial of postoperative adjuvant therapy in patients with completely resected stage II or IIIA non-smallcell lung cancer. Eastern Cooperative Oncology Group", N Engl J Med, 343, pp.1217~1222 (2000)
- Douillard JY, "Impact of postoperative radiation therapy on survival in patients with complete resection and stage I, II, or IIIA non-small-cell lung cancer treated with adjuvant chemotherapy : the adjuvant Navelbine International Trialist Association(ANITA)Randomized Trial", Int J Radiat Oncol Biol Phys, 72, pp.695~701 (2008)
- Scotti V, "Post-operative radiotherapy in N2 non-small cell lung cancer : a retrospective analysis of 175 patients", Radiother Oncol, 96, pp.84~88 (2010)
- Dai H, "Postoperative radiotherapy for resected pathological stage IIIA-N2 nonsmall cell lung cancer : a retrospective study of 221 cases from a single institution", Oncologist, 16, pp.641~650 (2011)
- Kim BH, "Role of postoperative radiotherapy after curative resection and adjuvant chemotherapy for patients with pathological stage N2 non-small-cell lung cancer : a propensity score matching analysis", Clin Lung Cancer, 15, pp.356~364 (2014)
- ) : a randomised controlled trial, "Lancet Oncol", 2006, 719~727
- Lally BE, "Postoperative radiotherapy for stage II or III non-small-cell lung cancer using the surveillance, epidemiology, and end results database", J Clin Oncol, 24, pp.2998~3006 (2006)
- Robinson CG, "Postoperative radiotherapy for pathologic N2 non-small-cell lung cancer treated with adjuvant chemotherapy : a review of the National Cancer Data Base", J Clin Oncol, 33, pp.870~876 (2015)
- Le Pechoux C, "Role of postoperative radiotherapy in resected non-small cell lung cancer : a reassessment based on new data", Oncologist, 16, pp.672~681 (2011)
