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Original Articles
- Role of Adjuvant Thoracic Radiation Therapy and Full Dose Chemotherapy in pN2 Non-small Cell Lung Cancer: Elucidation Based on Single Institute Experience
- Hyojung Park, Dongryul Oh, Yong Chan Ahn, Hongryull Pyo, Jae Myung Noh, Jong-Mu Sun, Jin Seok Ahn, Myung-Ju Ahn, Keunchil Park, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Jae Ill Zo, Young Mog Shim
- Cancer Res Treat. 2017;49(4):880-889. Published online December 12, 2016
- DOI: https://doi.org/10.4143/crt.2016.442
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Abstract
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ePub - Purpose
The optimal adjuvant therapy modality for treating pN2 non-small cell lung cancer patients has not yet been established. In this study, the authors investigated clinical outcomes following three different adjuvant therapy modalities.
Materials and Methods
From January 2006 to December 2012, 240 patients with cN0/1 disease were found to have pN2 disease following curative resection and received one of three adjuvant therapy modalities:thoracic radiation therapy (TRT) and concurrent chemotherapy (CTx) (CCRT) (group I), CCRT plus consolidation CTx (group II), and CTx alone (group III). TRT was delivered to 155 patients (groups I/II), and full dose CTxwas delivered to 172 patients either as a consolidative or a sole modality (group II/III).
Results
During 30 months of median follow-up, 44 patients died and 141 developed recurrence. The 5-year overall survival (OS), locoregional control (LRC), distant metastasis-free survival (DMFS), and disease-free survival (DFS) rates of all patients were 76.2%, 80.7%, 36.4%, and 29.6%, respectively. There was no difference in OS among groups. TRT (groups I/II) significantly improved LRC, full dose CTx (groups II/III) did DMFS, and CCRT plus consolidation CTx (group II) did DFS, respectively.
Conclusion
The current study could support that TRT could improve LRC and full dose CTx could improve DMFS and that CCRT plus consolidation CTx could improve DFS. -
Citations
Citations to this article as recorded by
- The effect of adjuvant chemoradiotherapy on survival after R0 resection for stage III-N2 nonsmall cell lung cancer: A meta-analysis
Dailong Li, Wanqiang Li, Yaqi Pang, Lu Xu, Xinhua Xu
Medicine.2022; 101(28): e29580. CrossRef - The efficacy of postoperative radiotherapy for patients with non-small cell lung cancer
Zexu Wang, Baixia Yang, Ping Zhan, Li Wang, Bing Wan
Journal of Cancer Research and Therapeutics.2022; 18(7): 1910. CrossRef
- The effect of adjuvant chemoradiotherapy on survival after R0 resection for stage III-N2 nonsmall cell lung cancer: A meta-analysis
- 44,523 View
- 260 Download
- 3 Web of Science
- 2 Crossref
- Definitive Bimodality Concurrent Chemoradiotherapy in Patients with Inoperable N2-positive Stage IIIA Non-small Cell Lung Cancer
- Jae Myoung Noh, Yong Chan Ahn, Hyebin Lee, Hongryull Pyo, BoKyong Kim, Dongryul Oh, Hyojung Park, Eonju Lee, Keunchil Park, Jin Seok Ahn, Myung-Ju Ahn, Jong-Mu Sun
- Cancer Res Treat. 2015;47(4):645-652. Published online February 12, 2015
- DOI: https://doi.org/10.4143/crt.2014.144
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Abstract
PDFPubReaderePub
- Purpose
This study was conducted to evaluate the treatment outcomes following definitive bimodality concurrent chemoradiotherapy (CCRT) in patients with inoperable N2-positive stage IIIA (N2- IIIA) non-small cell lung cancer (NSCLC). Materials and Methods From May 1997 to December 2012, 65 out of 633 patients with N2-IIIA NSCLC received bimodality therapy. The treatment modality was selected during/after neoadjuvant CCRT in 21 patients or primarily at diagnosis in 44 through a multidisciplinary consensus meeting. The median age was 65 years (range, 36 to 76 years). Sixty patients (92.3%) had clinically evident N2 disease, while 22 (33.8%) had multi-station N2 involvement. The median radiation therapy dose was 66 Gy in 33 fractions, while the dose was elevated to 72 Gy in 13 patients who had a treatment break due to delayed decision regarding resectability. The most frequent chemotherapy regimen was weekly paclitaxel or docetaxel plus cisplatin or carboplatin (54, 83.1%).
Results
During the median follow-up of 18.8 months (range, 1.6 to 173.1 months), 34 patients (52.3%) experienced disease progression, with distant metastasis being the most common first treatment failure pattern (23, 34.8%). The median and 2-year rates of progression-free survival were 18.8 months and 45.9%, respectively. The median and 2-year rates of overall survival were 28.6 months and 50.1%, respectively. Conclusion Definitive bimodality therapy in patients with N2-IIIA NSCLC demonstrated favorable outcomes, while trimodality therapy could be considered for candidates for less than pneumonectomy. -
Citations
Citations to this article as recorded by- Clinical N Staging Subclassification for Stage III-N2 NSCLC Patients Undergoing Trimodality Therapy: A Good Beginning Is Half the Battle
Junghee Lee, Yun Soo Hong, Jin Lee, Genehee Lee, Danbee Kang, Jiyoun Park, Yeong Jeong Jeon, Seong Yong Park, Jong Ho Cho, Yong Soo Choi, Jhingook Kim, Young Mog Shim, Eliseo Guallar, Juhee Cho, Hong Kwan Kim
The Annals of Thoracic Surgery.2025;[Epub] CrossRef - Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
Kyungmi Yang, Yang-Gun Suh, Hyunju Shin, Hongryull Pyo, Sung Ho Moon, Yong Chan Ahn, Dongryul Oh, Eunah Chung, Kwanghyun Jo, Jae Myoung Noh
Life.2022; 12(2): 292. CrossRef - Salvage proton beam therapy for locoregional recurrence of non-small cell lung cancer
Hyunju Shin, Jae Myoung Noh, Hongryull Pyo, Yong Chan Ahn, Dongryul Oh
Radiation Oncology Journal.2021; 39(1): 24. CrossRef - Experiences of patients with lung cancer receiving concurrent chemo-radiotherapy
Choi Eunsook, Park Sunhee
Clinical Journal of Nursing Care and Practice.2021; 5(1): 015. CrossRef - Prognostic significance of tumor poliovirus receptor and CTLA4 expression in patients with surgically resected non-small-cell lung cancer
Hui You, Yi-Zhong Zhang, Huan-Ling Lai, Dan Li, Yu-Quan Liu, Run-Ze Li, Imran Khan, Wendy Wen-Lun Hsiao, Fu-Gang Duan, Xing-Xing Fan, Xiao-Jun Yao, Ya-Bing Cao, Qi-Biao Wu, Elaine Lai-Han Leung, Mei-Fang Wang
Journal of Cancer Research and Clinical Oncology.2020; 146(6): 1441. CrossRef - Erlotinib as Neoadjuvant Therapy in Stage IIIA (N2) EGFR Mutation-Positive Non-Small Cell Lung Cancer: A Prospective, Single-Arm, Phase II Study
Liwen Xiong, Rong Li, Jiayuan Sun, Yuqing Lou, Weiyan Zhang, Hao Bai, Huiming Wang, Jie Shen, Bo Jing, Chunlei Shi, Hua Zhong, Aiqin Gu, Liyan Jiang, Jianxing Shi, Wentao Fang, Heng Zhao, Jie Zhang, Junyuan Wang, Junyi Ye, Baohui Han
The Oncologist.2019; 24(2): 157. CrossRef - Recurrence dynamics after trimodality therapy (Neoadjuvant concurrent chemoradiotherapy and surgery) in patients with stage IIIA (N2) lung cancer
Junghee Lee, Hong Kwan Kim, Byung Jo Park, Jong Ho Cho, Yong Soo Choi, Jae Ill Zo, Young Mog Shim, Hongryull Pyo, Yong Chan Ahn, Jin Seok Ahn, Myung-Ju Ahn, Keunchil Park, Jhingook Kim
Lung Cancer.2018; 115: 89. CrossRef
- Clinical N Staging Subclassification for Stage III-N2 NSCLC Patients Undergoing Trimodality Therapy: A Good Beginning Is Half the Battle
- 14,072 View
- 89 Download
- 5 Web of Science
- 7 Crossref
- Effect of Radiation Therapy Techniques on Outcome in N3-positive IIIB Non-small Cell Lung Cancer Treated with Concurrent Chemoradiotherapy
- Jae Myoung Noh, Jin Man Kim, Yong Chan Ahn, Hongryull Pyo, BoKyong Kim, Dongryul Oh, Sang Gyu Ju, Jin Sung Kim, Jung Suk Shin, Chae-Seon Hong, Hyojung Park, Eonju Lee
- Cancer Res Treat. 2016;48(1):106-114. Published online February 12, 2015
- DOI: https://doi.org/10.4143/crt.2014.131
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Abstract
PDFPubReaderePub
- Purpose
This study was conducted to evaluate clinical outcomes following definitive concurrent chemoradiotherapy (CCRT) for patients with N3-positive stage IIIB (N3-IIIB) non-small cell lung cancer (NSCLC), with a focus on radiation therapy (RT) techniques. Materials and Methods From May 2010 to November 2012, 77 patients with N3-IIIB NSCLC received definitive CCRT (median, 66 Gy). RT techniques were selected individually based on estimated lung toxicity, with 3-dimensional conformal RT (3D-CRT) and intensity-modulated RT (IMRT) delivered to 48 (62.3%) and 29 (37.7%) patients, respectively. Weekly docetaxel/paclitaxel plus cisplatin (67, 87.0%) was the most common concurrent chemotherapy regimen.
Results
The median age and clinical target volume (CTV) were 60 years and 288.0 cm3, respectively. Patients receiving IMRT had greater disease extent in terms of supraclavicular lymph node (SCN) involvement and CTV ≥ 300 cm3. The median follow-up time was 21.7 months. Fortyfive patients (58.4%) experienced disease progression, most frequently distant metastasis (39, 50.6%). In-field locoregional control, progression-free survival (PFS), and overall survival (OS) rates at 2 years were 87.9%, 38.7%, and 75.2%, respectively. Although locoregional control was similar between RT techniques, patients receiving IMRT had worse PFS and OS, and SCN metastases from the lower lobe primary tumor and CTV ≥ 300 cm3were associated with worse OS. The incidence and severity of toxicities did not differ significantly between RT techniques. Conclusion IMRT could lead to similar locoregional control and toxicity, while encompassing a greater disease extent than 3D-CRT. The decision to apply IMRT should be made carefully after considering oncologic outcomes associated with greater disease extent and cost. -
Citations
Citations to this article as recorded by- Pneumonitis Risk After Chemoradiotherapy With and Without Immunotherapy in Patients With Locally Advanced Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis
Chong Han, Jingping Qiu, Lu Bai, Tingting Liu, Jun Chen, He Wang, Jun Dang
International Journal of Radiation Oncology*Biology*Physics.2024; 119(4): 1179. CrossRef - “Mid-P strategy” versus “internal target volume strategy in locally advanced non small cell lung cancer: Clinical results from the randomized non-comparative phase II study Mid-P
Line Claude, Camille Schiffler, Vanina Isnardi, Séverine Metzger, Sophie Darnis, Isabelle Martel-Lafay, Thomas Baudier, Simon Rit, David Sarrut, Myriam Ayadi
Radiotherapy and Oncology.2024; 199: 110435. CrossRef - Comparison of post-chemoradiotherapy pneumonitis between Asian and non-Asian patients with locally advanced non-small cell lung cancer: a systematic review and meta-analysis
Tingting Liu, Sihan Li, Silu Ding, Jingping Qiu, Chengbo Ren, Jun Chen, He Wang, Xiaoling Wang, Guang Li, Zheng He, Jun Dang
eClinicalMedicine.2023; 64: 102246. CrossRef - The effect of radiotherapy and surgery on stage IIIA/B NSCLC patients treated with chemotherapy
Y. Zeng, G. Wang, H. Zheng, Y. Wang, G. Ma, Z. Pang, J. Du
International Journal of Radiation Research.2023; 21(3): 475. CrossRef - Toxicity of Proton Therapy versus Photon Therapy on Salvage Re-Irradiation for Non-Small Cell Lung Cancer
Kyungmi Yang, Yang-Gun Suh, Hyunju Shin, Hongryull Pyo, Sung Ho Moon, Yong Chan Ahn, Dongryul Oh, Eunah Chung, Kwanghyun Jo, Jae Myoung Noh
Life.2022; 12(2): 292. CrossRef - Durvalumab After Chemoradiation for Unresectable Stage III Non-Small Cell Lung Cancer: Inferior Outcomes and Lack of Health Equity in Hispanic Patients Treated With PACIFIC Protocol (LA1-CLICaP)
Luis E. Raez, Oscar Arrieta, Diego F. Chamorro, Pamela Denisse Soberanis-Piña, Luis Corrales, Claudio Martín, Mauricio Cuello, Suraj Samtani, Gonzalo Recondo, Luis Mas, Zyanya Lucia Zatarain-Barrón, Alejandro Ruíz-Patiño, Juan Esteban García-Robledo, Cami
Frontiers in Oncology.2022;[Epub] CrossRef - Clinical Impact of Supraclavicular Lymph Node Involvement of Stage IIIC Non-Small Cell Lung Cancer Patients
Sunmin Park, Won Sup Yoon, Mi Hee Jang, Chai Hong Rim
Medicina.2021; 57(3): 301. CrossRef - Salvage proton beam therapy for locoregional recurrence of non-small cell lung cancer
Hyunju Shin, Jae Myoung Noh, Hongryull Pyo, Yong Chan Ahn, Dongryul Oh
Radiation Oncology Journal.2021; 39(1): 24. CrossRef - Comparaison dosimétrique et de la toxicité de la radiothérapie conformationnelle avec modulation d’intensité et de la radiothérapie conformationnelle tridimensionnelle des carcinomes bronchiques non à petites cellules
F. Guillemin, L. Berger, M. Lapeyre, A. Bellière-Calandry
Cancer/Radiothérapie.2021; 25(8): 747. CrossRef - Real world data of durvalumab consolidation after chemoradiotherapy in stage III non-small-cell lung cancer
Hyun Ae Jung, Jae Myoung Noh, Jong-Mu Sun, Se-Hoon Lee, Jin Seok Ahn, Myung-Ju Ahn, Hongryull Pyo, Yong Chan Ahn, Keunchil Park
Lung Cancer.2020; 146: 23. CrossRef - Early blood rise in auto‑antibodies to nuclear and smooth muscle antigens is predictive of prolonged survival and autoimmunity in metastatic‑non‑small cell lung cancer patients treated with PD‑1 immune‑check point blockade by nivolumab
Rocco Giannicola, Graziella D'Arrigo, Cirino Botta, Rita Agostino, Pietro Del Medico, Antonia Falzea, Vito Barbieri, Nicoletta Staropoli, Teresa Del Giudice, Pierpaolo Pastina, Valerio Nardone, Marika Monoriti, Graziella Calabrese, Giovanni
Molecular and Clinical Oncology.2019;[Epub] CrossRef - Early tumor shrinkage served as a prognostic factor for patients with stage III non-small cell lung cancer treated with concurrent chemoradiotherapy
Min Wei, Qingqing Ye, Xuan Wang, Men Wang, Yan Hu, Yonghua Yang, Jiyuan Yang, Jun Cai
Medicine.2018; 97(19): e0632. CrossRef - Dosimetric advantages of intensity modulated radiation therapy in locally advanced lung cancer
John Boyle, Brad Ackerson, Lin Gu, Chris R. Kelsey
Advances in Radiation Oncology.2017; 2(1): 6. CrossRef - Normal lung sparing Tomotherapy technique in stage III lung cancer
Chae-Seon Hong, Sang Gyu Ju, Yong Chan Ahn, Gyu Sang Yoo, Jae Myoung Noh, Dongryul Oh, Kwangzoo Chung, Hongryull Pyo, Kwanghyun Jo
Radiation Oncology.2017;[Epub] CrossRef - Superior sulcus non-small cell lung carcinoma: A comparison of IMRT and 3D-RT dosimetry
Pierre Truntzer, Delphine Antoni, Nicola Santelmo, Catherine Schumacher, Pierre-Emmanuel Falcoz, Elisabeth Quoix, Gilbert Massard, Georges Noël
Reports of Practical Oncology & Radiotherapy.2016; 21(5): 427. CrossRef - Cost of Intensity-modulated Radiation Therapy for Older Patients with Stage III Lung Cancer
Minal S. Kale, Grace Mhango, Marcelo Bonomi, Alex Federman, Keith Sigel, Kenneth E. Rosenzweig, Juan P. Wisnivesky
Annals of the American Thoracic Society.2016; 13(9): 1593. CrossRef
- Pneumonitis Risk After Chemoradiotherapy With and Without Immunotherapy in Patients With Locally Advanced Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis
- 19,414 View
- 155 Download
- 20 Web of Science
- 16 Crossref
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