The role of postoperative radiotherapy (PORT) in combined small cell lung cancer (C-SCLC)

PURPOSE: To explore the value of radiotherapy in C-SCLC patients, especially in those receiving a radical resection. RESULTS: The differences of survivals between the postoperative radiotherapy (PORT) and non-PORT groups were not statistically significant. But analyzing the benefits in subgroups, PORT significantly improved OS (p = 0.015), DFS (p = 0.026), LRFS (p = 0.008) and DMFS (p = 0.030) in stage III patients. For the patients with N2 stage, all survivals of the PORT group were also statistically significantly higher than non-PORT group (p = 0.018, 0.032, 0.008, 0.042). Patients with more than 10% of metastatic lymph nodes could get a significant benefit survivals by receiving PORT (p = 0.033, 0.030, 0.025, 0.031). Having a systematic dissection of more than 17 lymph nodes was a subset which could get better OS and LRFS by receiving PORT (p = 0.045, 0.048). METHODS: Between Jan. 2004 to Dec. 2012, fifty-five patients diagnosed as C-SCLC after complete surgical resection in our center were retrospectively analyzed. The overall survival (OS), disease free survival (DFS), loco-regional recurrence free survival (LRFS), and distant metastasis free survival (DMFS) were calculated by Kaplan-Meier method. CONCLUSIONS: PORT can significantly improve the survival of C-SCLC patients with resected pathological pN2 stage. For the patients with a large percent of metastatic lymph nodes, PORT can also improve survivals.