Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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The single institutional outcome of postoperative radiotherapy and concurrent chemoradiotherapy in resected non-small cell lung cancer

  • Lee, Hyo Chun (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Yeon Sil (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Oh, Se Jin (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, Yun Hee (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, Dong Soo (Department of Medical Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Song, Jin Ho (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kang, Jin Hyung (Department of Medical Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Park, Jae Kil (Department of Thoracic Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine)
  • Received : 2014.05.02
  • Accepted : 2014.08.08
  • Published : 2014.09.30
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Abstract

Purpose: This study was conducted to observe the outcomes of postoperative radiotherapy (PORT) with or without concurrent chemotherapy in resected non-small cell lung cancer (NSCLC) in single institution. Materials and Methods: From 2002 to 2013, 78 patients diagnosed with NSCLC after curative resection were treated with radiotherapy alone (RT, n = 48) or concurrent chemoradiation (CCRT, n = 30). The indications of adjuvant radiation therapy were N2 node positive (n = 31), close or involved resection margin (n = 28), or gross residual disease due to incomplete resection (n = 19). The median radiation dose was 57.6 Gy (range, 29.9 to 66 Gy). Results: Median survival time was 33.7 months (range, 4.4 to 140.3 months). The 5-year overall survival (OS) rate was 49.5% (RT 46% vs. CCRT 55.2%; p = 0.731). The 3-year disease-free survival rate was 45.5% (RT 39.4% vs. CCRT 55.3%; p = 0.130). The 3-year local control rate was 68.1% (RT 64.4% vs. CCRT 77.7%; p = 0.165). The 3-year DMFS rate was 56.1% (RT 52.6% vs. CCRT 61.7%; p = 0.314). In multivariate analysis, age ${\geq}66$ years and pathologic stage III were significant poor prognostic factors for OS. Treatment failure occurred in 40 patients. Four patients had radiologically confirmed grade 3 radiation pneumonitis. Conclusion: In NSCLC, adjuvant RT or CCRT after curative surgery is a safe and feasible modality of treatment. OS gain was seen in patients less than 66 years. Postoperative CCRT showed a propensity of achieving better local control and improved disease-free survival compared to RT alone according to our data.

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