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W. Chen

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    P1.03 - Poster Session/ Treatment of Locoregional Disease – NSCLC (ID 212)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Locoregional Disease – NSCLC
    • Presentations: 1
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      P1.03-010 - Adjuvant Chemotherapy plus Radiotherapy is Superior to Chemotherapy in Surgically Treated IIIA N2 Non-Small-Cell Lung Cancer (ID 2831)

      09:30 - 17:00  |  Author(s): W. Chen

      • Abstract
      • Slides

      The role of addition radiotherapy for resected stage IIIA (N2) non-small cell lung cancer (NSCLC) in the setting of standard adjuvant chemotherapy remains controversial.

      A comprehensive search of PubMed, Embase, Medline database (last search updated in March 2015) for relevant studies comparing patients with stage IIIA (N2) NSCLC undergoing resection after treatment with adjuvant chemotherapy alone (POCT) or adjuvant chemoradiotherapy (POCRT) was conducted. Hazard ratios (HR) were extracted from these studies to give pooled estimates of the effect of POCRT on overall survival (OS) and disease free survival (DFS).

      A total of six studies including two randomized controlled trials (RCTs) and four retrospective studies were enrolled in this meta-analysis. There were 6 studies that met criteria for analysis, including 2 RCTs and 4 retrospective reviews. The meta-analysis enrolling all studies (5172 cases) demonstrated an OS benefit to POCRT versus POCT (HR 0.87, 95% confidence interval [CI] 0.79 to 0.96, p = 0.006). DFS was investigated in four studies including 2 RCTs and 2 retrospective reviews. Unfortunately, there was no significant difference in DFS of two groups for the combined HR for PFS was 0.86 (95% CI: 0.70-1.06; p = 0.158). The sub-group analysis performed on two RCTs (n = 172 patients) demonstrated no benefit from adding radiation in neither OS (HR 0.72, 95% CI 0.49 to 1.06, p = 0.094) nor DFS (HR 1.45, 95% CI 1.00 to 2.09, p = 0.047).

      Compared with POCT, POCRT had a benefit for OS but not DFS in the patients with IIIA-pN2 NSCLC. Considering the relatively small sample size of most studies and only included two RCTs, caution should be taken when adopting the conclusions. Future RCT to investigate the role of POCRT after surgical resection of stage IIIA (N2) NSCLC is warranted.

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