Division of the N2 Stage According to the Multiplicity of the Involved Nodal Stations May be Necessary in the N2-NSCLC Patients Who are Treated with Postoperative Radiotherapy / 대한방사선종양학회지
The Journal of the Korean Society for Therapeutic Radiology and Oncology
;
: 126-132, 2009.
Article
in Korean
| WPRIM
| ID: wpr-35652
ABSTRACT
PURPOSE:
We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. MATERIALS ANDMETHODS:
We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy.RESULTS:
The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage (> or =T3) had significantly reduced OS and DFS (p or =5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage (> or =T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients.CONCLUSION:
Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pneumonectomy
/
Recurrence
/
Mastectomy, Segmental
/
Multivariate Analysis
/
Retrospective Studies
/
Carcinoma, Non-Small-Cell Lung
/
Disease-Free Survival
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
The Journal of the Korean Society for Therapeutic Radiology and Oncology
Year:
2009
Type:
Article
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