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The single institutional outcome of postoperative radiotherapy and concurrent chemoradiotherapy in resected non-small cell lung cancer

Radiation Oncology Journal
2014년 32권 3호 p.147 ~ p.155
이효천 ( Lee Hyo-Chun ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiation Oncology

김연실 ( Kim Yeon-Sil ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiation Oncology
오세진 ( Oh Se-Jin ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiation Oncology
이연희 ( Lee Yun-Hee ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiation Oncology
이동수 ( Lee Dong-Soo ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Medical Oncology
송진호 ( Song Jin-Ho ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiation Oncology
강진형 ( Kang Jin-Hyung ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Medical Oncology
박재길 ( Park Jae-Kil ) - Catholic University College of Medicine Seoul St. Marys Hospital Department of Thoracic Surgery

Abstract

Purpose: This study was conducted to observe the outcomes of postoperative radiotherapy (PORT) with or without concurrent chemotherapy in resected non-small cell lung cancer (NSCLC) in single institution.

Materials and Methods: From 2002 to 2013, 78 patients diagnosed with NSCLC after curative resection were treated with radiotherapy alone (RT, n = 48) or concurrent chemoradiation (CCRT, n = 30). The indications of adjuvant radiation therapy were N2 node positive (n = 31), close or involved resection margin (n = 28), or gross residual disease due to incomplete resection (n = 19). The median radiation dose was 57.6 Gy (range, 29.9 to 66 Gy).

Results: Median survival time was 33.7 months (range, 4.4 to 140.3 months). The 5-year overall survival (OS) rate was 49.5% (RT 46% vs. CCRT 55.2%; p = 0.731). The 3-year disease-free survival rate was 45.5% (RT 39.4% vs. CCRT 55.3%; p = 0.130). The 3-year local control rate was 68.1% (RT 64.4% vs. CCRT 77.7%; p = 0.165). The 3-year DMFS rate was 56.1% (RT 52.6% vs. CCRT 61.7%; p = 0.314). In multivariate analysis, age ≥66 years and pathologic stage III were significant poor prognostic factors for OS. Treatment failure occurred in 40 patients. Four patients had radiologically confirmed grade 3 radiation pneumonitis.

Conclusion: In NSCLC, adjuvant RT or CCRT after curative surgery is a safe and feasible modality of treatment. OS gain was seen in patients less than 66 years. Postoperative CCRT showed a propensity of achieving better local control and improved disease-free survival compared to RT alone according to our data.

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