Title of article :
Effectiveness of Postoperative Irradiation in Stage IIIA Non–Small Cell Lung Cancer According to Regression Tree Analyses of Recurrence Risks
Author/Authors :
Timothy E. Sawyer MD، نويسنده , , James A. Bonner MD، نويسنده , , Perry M. Gould MD، نويسنده , , Robert L. Foote MD، نويسنده , , Claude Deschamps MD، نويسنده , , Victor F. Trastek MD، نويسنده , , Peter C. Pairolero MD، نويسنده , , Mark S. Allen MD، نويسنده , , Carla M. Lange BS، نويسنده , , Hongzhe Li PhD، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 1997
Pages :
6
From page :
1402
To page :
1407
Abstract :
Background. In the setting of grossly resected stage IIIA (N2 involvement) non–small cell lung carcinoma, the role of adjuvant postoperative thoracic radiation therapy (TRT) remains controversial. This study was initiated to subcategorize these patients into high-, intermediate-, and low-risk groups with respect to local recurrence and survival rates, and to determine whether there were certain subgroups of patients who were particularly likely or unlikely to benefit from postoperative TRT. Methods. Two hundred twenty-four patients were studied. A regression tree analysis was used to separate patients who had undergone operation alone into groups that had a high, intermediate, or low risk of local recurrence and death. The effect of adjuvant postoperative TRT then was examined in each of these groups. Results. The use of adjuvant postoperative TRT (compared with operation alone) was associated with an improvement in freedom from local recurrence and survival for patients who had an intermediate or high risk of local recurrence and death. However, the greatest level of improvement in freedom from local recurrence (p < 0.0001) and survival (p = 0.0002) associated with the use of adjuvant postoperative TRT was in the high-risk group. Similarly, but of lesser magnitude, the intermediate-risk group had improved freedom from local recurrence and survival rates with the use of adjuvant postoperative TRT (p = 0.002 and p = 0.01, respectively). For the low-risk group, the freedom from local recurrence and survival rates were not statistically different between the patients who received adjuvant postoperative TRT and those who underwent observation. Conclusions. Patients with non–small cell lung carcinoma involving ipsilateral mediastinal lymph nodes (stage IIIA) who undergo gross resection and who are at either high or intermediate risk for local recurrence and death are likely to benefit from adjuvant postoperative irradiation. The role of radiation therapy in low-risk patients is unclear. Prospective confirmation of these observations is warranted.
Journal title :
The Annals of Thoracic Surgery
Serial Year :
1997
Journal title :
The Annals of Thoracic Surgery
Record number :
614656
Link To Document :
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