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Role of Adjuvant Radiotherapy in Non-Small Cell Lung Cancer—A Review

SIMPLE SUMMARY: The role of postoperative radiotherapy (PORT) in completely resected non-small cell lung cancer (NSCLC) with ipsilateral mediastinal lymph node involvement (pN2) is controversial. The aim of our review was to study the literature relating to PORT for completely resected NSCLC patient...

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Autores principales: Süveg, Krisztian, Plasswilm, Ludwig, Iseli, Thomas, Leskow, Pawel, Fischer, Galina Farina, Putora, Paul Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8997169/
https://www.ncbi.nlm.nih.gov/pubmed/35406388
http://dx.doi.org/10.3390/cancers14071617
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author Süveg, Krisztian
Plasswilm, Ludwig
Iseli, Thomas
Leskow, Pawel
Fischer, Galina Farina
Putora, Paul Martin
author_facet Süveg, Krisztian
Plasswilm, Ludwig
Iseli, Thomas
Leskow, Pawel
Fischer, Galina Farina
Putora, Paul Martin
author_sort Süveg, Krisztian
collection PubMed
description SIMPLE SUMMARY: The role of postoperative radiotherapy (PORT) in completely resected non-small cell lung cancer (NSCLC) with ipsilateral mediastinal lymph node involvement (pN2) is controversial. The aim of our review was to study the literature relating to PORT for completely resected NSCLC patients with pN2 involvement. The Lung ART and PORT-C trials indicate better locoregional control with PORT, but this has not yet translated into survival benefits. Given the conflicting results, guidelines do not recommend the use of PORT routinely. Future research should focus on identifying subgroups of patients who might benefit from PORT. ABSTRACT: Background: For patients with completely resected non-small cell lung cancer (NSCLC) with ipsilateral mediastinal lymph node involvement (pN2), the administration of adjuvant chemotherapy is the standard of care. The role of postoperative radiation therapy (PORT) is controversial. Methods: We describe the current literature focusing on the role of PORT in completely resected NSCLC patients with pN2 involvement and reflect on its role in current guidelines. Results: Based on the results of the recent Lung ART and PORT-C trials, the authors conclude that PORT cannot be generally recommended for all resected pN2 NSCLC patients. A substantial decrease in the locoregional relapse rate without translating into a survival benefit suggests that some patients with risk factors might benefit from PORT. This must be balanced against the risk of cardiopulmonary toxicity with potentially associated mortality. Lung ART has already changed the decision making for the use of PORT in daily practice for many European lung cancer experts, with lower rates of recommendations for PORT overall. Conclusions: PORT is still used, albeit decreasingly, for completely resected NSCLC with pN2 involvement. High-level evidence for its routine use is lacking. Further analyses are required to identify patients who would potentially benefit from PORT.
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spelling pubmed-89971692022-04-12 Role of Adjuvant Radiotherapy in Non-Small Cell Lung Cancer—A Review Süveg, Krisztian Plasswilm, Ludwig Iseli, Thomas Leskow, Pawel Fischer, Galina Farina Putora, Paul Martin Cancers (Basel) Review SIMPLE SUMMARY: The role of postoperative radiotherapy (PORT) in completely resected non-small cell lung cancer (NSCLC) with ipsilateral mediastinal lymph node involvement (pN2) is controversial. The aim of our review was to study the literature relating to PORT for completely resected NSCLC patients with pN2 involvement. The Lung ART and PORT-C trials indicate better locoregional control with PORT, but this has not yet translated into survival benefits. Given the conflicting results, guidelines do not recommend the use of PORT routinely. Future research should focus on identifying subgroups of patients who might benefit from PORT. ABSTRACT: Background: For patients with completely resected non-small cell lung cancer (NSCLC) with ipsilateral mediastinal lymph node involvement (pN2), the administration of adjuvant chemotherapy is the standard of care. The role of postoperative radiation therapy (PORT) is controversial. Methods: We describe the current literature focusing on the role of PORT in completely resected NSCLC patients with pN2 involvement and reflect on its role in current guidelines. Results: Based on the results of the recent Lung ART and PORT-C trials, the authors conclude that PORT cannot be generally recommended for all resected pN2 NSCLC patients. A substantial decrease in the locoregional relapse rate without translating into a survival benefit suggests that some patients with risk factors might benefit from PORT. This must be balanced against the risk of cardiopulmonary toxicity with potentially associated mortality. Lung ART has already changed the decision making for the use of PORT in daily practice for many European lung cancer experts, with lower rates of recommendations for PORT overall. Conclusions: PORT is still used, albeit decreasingly, for completely resected NSCLC with pN2 involvement. High-level evidence for its routine use is lacking. Further analyses are required to identify patients who would potentially benefit from PORT. MDPI 2022-03-23 /pmc/articles/PMC8997169/ /pubmed/35406388 http://dx.doi.org/10.3390/cancers14071617 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Süveg, Krisztian
Plasswilm, Ludwig
Iseli, Thomas
Leskow, Pawel
Fischer, Galina Farina
Putora, Paul Martin
Role of Adjuvant Radiotherapy in Non-Small Cell Lung Cancer—A Review
title Role of Adjuvant Radiotherapy in Non-Small Cell Lung Cancer—A Review
title_full Role of Adjuvant Radiotherapy in Non-Small Cell Lung Cancer—A Review
title_fullStr Role of Adjuvant Radiotherapy in Non-Small Cell Lung Cancer—A Review
title_full_unstemmed Role of Adjuvant Radiotherapy in Non-Small Cell Lung Cancer—A Review
title_short Role of Adjuvant Radiotherapy in Non-Small Cell Lung Cancer—A Review
title_sort role of adjuvant radiotherapy in non-small cell lung cancer—a review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8997169/
https://www.ncbi.nlm.nih.gov/pubmed/35406388
http://dx.doi.org/10.3390/cancers14071617
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