Open AccessSelection of proper candidates with resected pathological stage IIIA‐N2 non‐small cell lung cancer for postoperative radiotherapy
Author(s) -
Hui Zhouguang,
Dai Honghai,
Liang Jun,
Lv Jima,
Zhou Zongmei,
Feng Qinfu,
Xiao Zefen,
Chen Dongfu,
Zhang Hongxing,
Yin Weibo,
Wang Luhua
Publication year - 2015
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.12186
Subject(s) - medicine , port (circuit theory) , lung cancer , stage (stratigraphy) , radiation therapy , pathological , oncology , surgery , electrical engineering , biology , engineering , paleontology
Abstract Background To establish a prediction model in selecting fit patients with resected p IIIA‐N2 non‐small cell lung cancer ( NSCLC) for postoperative radiotherapy ( PORT ), and evaluate the model in clinical practice. Methods Between J anuary 2003 and D ecember 2005, 221 patients with resected p IIIA‐N2 NSCLC were retrospectively analyzed. The effect of PORT on overall survival ( OS ) of patients with different clinicopathological factors was evaluated and the results were used to establish a prediction model to select patients fit for PORT . Results Compared with the control, PORT significantly improved the OS of patients with a smoking index ≤400 ( P = 0.033), cN2 ( P = 0.003), pT3 ( P = 0.014), squamous cell carcinoma ( SCC) ( P = 0.013), or ≥4 positive nodes ( P = 0.025). Patients were divided from zero to all five factors into low, middle, and high PORT index ( PORT ‐ I ) groups (scored 0–1, 2, and 3–5, respectively). PORT did not improve OS (3‐year, P = 0.531), disease free survival ( DFS ) ( P = 0.358), or loco‐regional recurrence free survival ( LRFS ) ( P = 0.412) in the low PORT ‐ I group. PORT significantly improved OS ( P = 0.033), and tended to improve DFS ( P = 0.064), but not LRFS ( P = 0.287) in the middle PORT ‐ I group. PORT could significantly improve OS ( P = 0.000), DFS ( P = 0.000), and LRFS ( P = 0.006) in the high PORT ‐ I group. Conclusion The prediction model is valuable in selecting patients with resected p IIIA‐N2 NSCLC fit for PORT . PORT is strongly recommended for patients with three or more of the five factors of smoking index ≤400, cN2 , pT3 , SCC , and ≥4 positive nodes.