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Abstract 

Postoperative radiation therapy (PORT) and postoperative chemotherapy (POCT) can be administered as adjuvant therapies in patients with non-small cell lung cancer (NSCLC). The aim of this study was to present the clinical outcomes in patients treated with PORT-first with or without subsequent POCT in stage IIIA-N2 NSCLC.

METHODS AND MATERIALS:

From January 2002 to November 2014, the conditions of 105 patients with stage IIIA-N2 NSCLC who received PORT-first with or without subsequent POCT were analyzed. PORT was initiated within 4 to 6 weeks after surgical resection. Platinum-based POCT was administered 3 to 4 weeks after the completion of PORT. We analyzed the outcomes and the clinical factors affecting survival.

RESULTS:

Of 105 patients, 43 (41.0%) received POCT with a median of 4 cycles (range, 2-6 cycles). The follow-up times ranged from 3 to 123 months (median, 30 months), and the 5-year overall survival (OS) was 40.2%. The 5-year OS of patients treated with PORT and POCT was significantly higher than that of patients with PORT (61.3% vs 29.2%, P<.001). The significant prognostic factors affecting OS were the use of POCT (hazard ratio [HR] = 0.453, P=.036) and type of surgery (pneumonectomy/lobectomy; HR = 2.845, P<.001).

CONCLUSIONS:

PORT-first strategy after surgery appeared not to compromise the clinical outcomes in the treatment of stage IIIA-N2 NSCLC. The benefit of POCT on OS was preserved even in the PORT-first setting. Further studies are warranted to compare the sequencing of PORT and POCT, guaranteeing the proper use of POCT. 

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Author information​

Lee HW1, Noh OK2, Oh YT3, Choi JH1, Chun M3, Kim HI3, Heo J3, Ahn MS1, Park SY4, Park RW5, Yoon D5.

1Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.

2Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: okyu.noh@gmail.com.

3Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Republic of Korea.

4Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.

5Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea.