Post-operative radiotherapy in N2 non-small cell lung cancer: A retrospective analysis of 175 patients

Background and purposePost-operative radiotherapy (PORT) in radically resected non-small cell lung cancer (NSCLC) has the aim to reduce loco regional recurrence and to improve overall survival. PORT has been evaluated in several trials but indication to post-operative treatment in N2 patients is still debated.Material and methodsWe retrospectively analyzed 175 patients treated at University of Florence between 1988 and 2004 with completely resected NSCLC stages IIIA–IIIB, N2 disease. Surgery consisted in a lobectomy in 58.9% and in a bi-lobectomy or in a pneumonectomy in 41.1% of patients. One hundred and nineteen patients underwent PORT and 56 patients did not receive PORT (no-PORT).ResultsAt a median follow-up of 27.6 months (range 4–233 months), we found a significant reduction in local recurrence (LR) in PORT group (log-rank test p = 0.015; HR: 0.45; 95%CI: 0.24–0.87). No statistical difference were found in terms of overall survival (OS) (log-rank test p = 0.92). Concerning other prognostic factors, male sex emerged as statistically significant (HR:4.33;1.04–18.02) on local progression free survival (LPFS) at univariate analysis. Acute and long-term toxicity was mild.ConclusionOur retrospective analysis showed that PORT may improve local disease control in N2 NSCLC patients with an acceptable treatment-related toxicity.