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Benefits of postoperative radiotherapy in multimodality treatment of resected small-cell lung cancer with lymph node metastasis
Ist Teil von
European journal of surgical oncology, 2014-09, Vol.40 (9), p.1156-1162
Ort / Verlag
England: Elsevier Ltd
Erscheinungsjahr
2014
Quelle
MEDLINE
Beschreibungen/Notizen
Abstract Aim The purpose of this study is to evaluate the role of postoperative radiotherapy (PORT) in resected small-cell lung cancer (SCLC). Methods: This study retrospectively analyzed 143 patients with completely resected SCLC in our institution between 1996 and 2011. The primary endpoint was overall survival (OS). The log-rank test and Cox regression model were used to evaluate the factors influencing local-regional recurrence (LRR) and OS. Results The median OS for the entire population was 34 months, and the 5-year OS rate was 34.6%. In multivariate analysis, age, surgical procedure, pathology stage, adjuvant chemotherapy and distant relapse were significant factors for survival. For the whole population, PORT had no effect on OS, with a median OS of 40 months in the PORT group versus 27 months in the non-PORT group ( p = 0.260). However, in patients with N1 disease, the median OS were 40 months in the PORT group versus 14 months in the non-PORT group ( p = 0.032). The corresponding OS in N2 patients were 35 months versus 17 months, respectively ( p = 0.040). Similarly, PORT significantly reduced the LRR in patients with positive lymph node. For patients with N1 disease, the 3-year LRR rate was 0.0% in the PORT group versus 14.3% in the non-PORT group ( p = 0.037). The corresponding LLR rate in N2 patients was 4.2% versus 56.6% ( p < 0.001). Conclusion PORT significantly reduced LRR and improved OS in patients with regional metastasis SCLC. We suggest supplementing PORT in the multimodality treatment of resected SCLC with lymph node metastasis.