Evaluating the benefits of radiotherapy after surgery in patients with resectable stage III-N2 non-small cell lung cancer.

This study evaluated the benefits of postoperative radiotherapy (PORT; radiation after surgery) in patients with resectable stage III-N2 non-small-cell lung cancer (NSCLC). The data showed that PORT significantly increased survival without disease progression and reduced the risk of cancer relapse for these patients.

NSCLC is the most common form of lung cancer. NSCLC is responsible for around 85% of all lung cancer diagnoses. Standard treatment for early-stage NSCLC involves surgical removal of solid tumors, chemotherapy (CT), and radiotherapy (RT). In patients with stage III-N2 NSCLC the cancer has spread from the lungs to the nearby lymph nodes in the chest.

Treatment of stage III-N2 NSCLC after surgery remains a challenge. After surgery, many patients are also treated with postoperative RT (PORT) and postoperative chemotherapy (POCT). This is to kill the remaining cancer cells. However, the benefits of PORT in patients with resectable stage III-N2 NSCLC are still unclear.

This study analyzed 7 studies that involved 1318 patients with resectable stage III-N2 NSCLC. Patients were divided into two groups. Group 1 included 659 patients who received PORT. Group 2 included 659 patients who did not receive PORT.

There was a slight improvement of 13% in overall survival for group 1 compared to group 2. Patients in group 1 had a significantly higher (by 17%) chance of survival without disease progression compared to those in group 2.

Patients treated with PORT also had a significantly lower (by 36%) risk of cancer recurrence in and around the original site of disease compared to those patients who were treated without PORT.

This study concluded that PORT significantly increased survival without disease progression and reduced the risk of cancer relapse for patients with stage III-N2 NSCLC. 

Important information such as patients’ age, sex, histology, and the number of lymph nodes was missing. There was limited data for survival analysis.