Evaluating the best timing of surgery after chemoradiotherapy in patients with locally advanced non-small cell lung cancer.

This study investigated the optimal time interval between chemoradiotherapy (CRT) and surgery and its impact on survival outcomes in patients with locally advanced (LA) non-small-cell lung cancer (NSCLC). The data showed that surgery within 7 weeks after CRT was associated with improved survival outcomes in 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 advanced NSCLC involves surgical removal of solid tumors and chemoradiotherapy (CRT). CRT involves administering both chemotherapy (CT) and performing radiation therapy (RT). CRT is commonly given before the surgical treatment to reduce tumor size. This is called neoadjuvant CRT (NCRT).

Studies suggest that the length of time between surgery and NCRT may affect response to treatment and long-term survival. However, the optimal time interval from NCRT to surgery and the impact of radiation dose on survival outcomes in patients with LA-NSCLC are still not clear.

This study involved 3489 patients with LA-NSCLC who were treated with NCRT and surgery. Patients were divided into 2 groups. Group 1 included 2311 patients who had surgery within 7 weeks after NCRT. Group 2 included 1178 patients who had surgery more than 7 weeks after NCRT. The average follow-up time was 57 months.

The average overall survival for group 1 was 56.9 months compared to 45.6 months for group 2. Patients in group 1 were 1.18 times more likely to have a better survival than patients in group 2.

Among 2902 patients who had lobectomy (one of the lobes of the lungs is removed), the mortality rate was 5.2% for surgery within 66 days versus 8.1% for surgery after 66 days. 

This study concluded that surgery within 7 weeks after NCRT and lobectomy within 66 days was associated with improved survival outcomes for patients with LA-NSCLC.

This study was based on medical records. The sample size was small. Further studies are required to validate the conclusions.