2Department of Radiation Oncology, Eskisehir Osmangazi University Faculty of Medicine, Eskişehir-Türkiye
3Department of Radiation Oncology, Dr. Suat Seren Chest Disease and Surgery Training Hospital, İzmir-Türkiye
4Department of Radiation Oncology, Ankara University Faculty of Medicine, Ankara-Türkiye
5Department of Radiation Oncology, Ege University Faculty of Medicine, İzmir-Türkiye
6Department of Radiation Oncology, Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul-Türkiye
7Department of Radiation Oncology, Necmettin Erbakan University Meram Faculty of Medicine, Konya-Türkiye
8Department of Radiation Oncology, Trakya University Faculty of Medicine, Edirne-Türkiye
9Department of Radiation Oncology, Dokuz Eylul University Faculty of Medicine, İzmir-Türkiye
10Department of Radiation Oncology, Bülent Ecevit University Faculty of Medicine, Zonguldak-Türkiye
11Department of Radiation Oncology, Balıkesir Government Hospital, Balıkesir-Türkiye DOI : 10.5505/tjo.2023.3921 OBJECTIVE
Post-operative radiotherapy (PORT) in non-small cell lung cancer (NSCLC), especially after complete resection, has long been an unresolved dilemma and debated among therapeutic disciplines. We aimed to evaluate the effects of different radiotherapy volumes and techniques on local-regional recurrence patterns and PORT results in patients with NSCLC.
METHODS
The results of 389 patients who underwent surgery and received PORT at 11 centers were analyzed
retrospectively. The surgical margin was positive or closes in 100 (26%) patients. The PORT dose was a
median of 50 Gy (36?60 Gy). Intensity-modulated RT methods were used in 68 (17.5%) patients.
RESULTS
The first recurrence of the patients who developed relapse, local recurrence was found in 77 (19.8%)
patients, distant recurrence was found in 95 (24%) patients, and both recurrences was found in 30 (8%)
patients. The median time to locoregional relapse was 14 months (1.84?59.7 months). Local-regional
recurrence was not significantly higher in patients with positive surgical margins than in negative patients
(39% vs. 29%, p=0.1), but the dose administered to these patients was also higher. Mediastinal
recurrence occurred in 28 (19%) patients who did not receive radiotherapy to the mediastinum; 25 of
these recurrences (89%) were just near or outside the field. Cardiac events became 7% in all groups and
did not change according to chosen mediastinal radiotherapy volume.
CONCLUSION
A clear description of the PORT volumes according to the localization of the primary tumor and the
involved lymph nodes would be beneficial in terms of establishing the recurrence/toxicity balance better.