Modern postoperative radiotherapy – a potential treatment for non-small cell lung cancer spread to the lymph nodes?

This study aimed to see whether combining postoperative radiotherapy (PORT) with adjuvant (following surgery) chemotherapy would be effective in patients with N2 (spread to lymph nodes around the lung) non-small-cell lung cancer (NSCLC). The researchers concluded that using PORT in combination with chemotherapy increased overall survival (OS, time from treatment until death from any cause).

N2 NSCLC is non-small-cell lung cancer that has spread to lymph nodes near the primary tumor. Currently, platinum-based chemotherapy after surgery is used to treat this type of cancer. Combining adjuvant chemotherapy with PORT has not been fully examined since the 1970’s, when PORT technology was less advanced and more toxic. It is possible therefore that modern PORT technology may increase OS in patients with N2 NSCLC.

This study aimed to assess whether included PORT would increase overall survival. 

Data from 4483 patients taken from the national cancer database were examined in this study. 1850 patients received both PORT and adjuvant chemotherapy (group 1), while 2633 patients did not receive PORT (group 2). The average follow-up for patients was 22 months.

Group 1 patients saw improvements in OS (45.2 months) compared to group 2 (40.9 months). The difference in OS between the groups was not significant until at least 2 years after treatment. The 5-year overall survival rate was 39.3% for group 1, compared to 34.8% in group 2.

Improved OS was associated with younger age, living in an urban area, smaller tumor size, use of multiple chemotherapy agents and lobectomy (surgical removal of a lobe within the lung).

This study concluded that combining PORT with adjuvant chemotherapy may have good potential in treating patients with N2 NSCLC.

The article does not outline adverse side effects or toxicity issues.

Consult with your doctor about the possibility of postoperative radiotherapy.