Chest
Clinical Investigations: CancerPostoperative Radiotherapy in Radically Resected Non-small Cell Lung Cancer
Section snippets
Study Population
All patients eligible for the study had histologic or cytologic evidence of NSCLC. Based on findings from physical examination, laboratory data, abdominal ultrasound, CT, and bone scans, all patients were free of distant metastases (M0). Bronchoscopy and esophagoscopy were performed in each patient. Mediastinoscopy was done only in patients with central tumors and/or enlarged mediastinum as detected on chest radiographs and/or CT. Patients with contralateral or high (above the azygos vein on
Survival Rate
The overall 5-year survival rate (median observation time, 43 months) of all patients was 24.1% (Fig 1). It was slightly better in the EBR group (29.7%) than in the control group (20.4%) (p<0.05, not significant). The relative risk of the EBR group was 0.85 with a two-sided confidence interval of 0.66 to 1.09. pNO patients had an overall survival of 40.9% (EBR group, 60.4%; control group, 32.3%) (p<0.05, not significant), pN1 patients had 26.1% (EBR group, 41.8%; control group, 22.1%) (p<0.05,
Discussion
For many years, postoperative EBR has been used frequently to prevent local failure in patients with breast cancer, rectal cancer, other pelvic malignancies, or soft-tissue sarcomas. Other rationales for using postoperative EBR in resected NSCLC are to prevent local recurrence and to increase long-term survival. A number of studies, both retrospective and prospective, have compared postoperative EBR with no further treatment in patients with resected NSCLC.
Green et al9 (1975) and Kirsh and Sloan
Conclusion
In summary, the current data indicate a significant reduction of local recurrence at the bronchial stump and/or mediastinum in patients with adjuvant postoperative EBR.
In contrast to other studies, there was no difference in the number of local relapses within the different histologic subgroups.10, 22 Neither age, sex, histologic subtype, tumor size, surgical approach, nor extent of lymph node involvement had prognostic value—only EBR had an independent influence on the risk of local
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