Lung cancer

What is the role of radiotherapy after surgery in the treatment of operable stage II NSCLC?

From Cancer Guidelines Wiki




What is the role of radiotherapy after surgery in the treatment of operable stage II NSCLC?

Introduction

Radiotherapy either to the tumour bed or to the regional lymph nodes may be employed after surgery to reduce local recurrence, and possibly improve survival. The role of external beam radiotherapy following complete resection of NSCLC has been extensively investigated, but there is less information on the role of radiotherapy following incomplete removal of the tumour.

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Postoperative external beam radiotherapy (PORT) versus no radiotherapy

There is strong evidence, based on an individual patient data meta-analysis and recently updated, that the use of postoperative radiotherapy following complete resection of stage II NSCLC is detrimental, and is associated with worse survival. [1]

In 718 patients with stage II disease randomised to PORT or no PORT, there was an increased risk of death with a hazard ratio was 1.24 (95% C.I.: 1.04, 1.52) in patients randomised to PORT.

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Evidence summary and recommendations

Evidence summary Level References
Following complete resection of stage II NSCLC, the addition of adjuvant external beam radiotherapy decreases survival

Last reviewed December 2015

I [1]
Evidence-based recommendationQuestion mark transparent.png Grade
In patients who have had complete resection of stage II NSCLC, postoperative radiotherapy is not recommended.

Last reviewed December 2015

A


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References

  1. 1.0 1.1 PORT Meta-analysis Trialists Group. Postoperative radiotherapy for non-small cell lung cancer. Cochrane Database Syst Rev 2005 Apr 18;(2):CD002142 Available from: http://www.ncbi.nlm.nih.gov/pubmed/15846628.

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Appendices

Further resources

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