Postoperative Radiotherapy Reduces Survival in Resected Non-Small Cell Lung Cancer

Previous research presented at the 2006 ASCO Annual Meeting observed an association between survival and postoperative radiotherapy (PORT) in patients with resected non-small cell lung cancer (NSCLC). Using the latest data, researchers revisited this relationship and found that PORT may be detrimental in patients with resected NSCLC. This work was presented at the 2019 ASCO Annual Meeting.

This updated information was taken from the Surveillance, Epidemiology, and End Results database. The researchers analyzed 20,645 patients with stage II/III NSCLC who were diagnosed between 1988 and 2014 and followed for a mean 3.3 years.

Factors associated with the use of PORT included age less than 50 years, T3-4 tumor stage, larger tumor size, advanced node stage, higher American Joint Committee on Cancer stage, greater number of lymph nodes involved, and a higher ratio of lymph nodes involved to lymph nodes sampled. Factors that negatively impacted survival were male sex, T3-4 tumor stage, older age, fewer sampled lymph nodes, N2 node stage, higher positive lymph nodes, and higher ratio of lymph nodes involved to lymph nodes sampled in a multivariate analysis.

PORT was found to have a significant negative impact on survival in both the N0 (P<0.001) and N1 subgroups (P<0.001) but not in the N2 subgroup (P<0.117). The authors noted that these results differ from those reported in 2006.

The researchers concluded that PORT is detrimental to patients with resected N0 and N1 NSCLC and its use should be avoided in such individuals. There is less certainty regarding the effect of PORT in patients with resected N2 NSCLC, and this “may warrant further research,” the researchers concluded.

Chen D, Li Y, Jing W, et al. Postoperative radiotherapy for stage II or III non–small cell lung from 1988 to 2014. Abstract #e20013. Presented at the 2019 ASCO Annual Meeting, Chicago, IL, May 31-June 4, 2019.