Commentary


Optimal sequencing of adjuvant chemotherapy and radiation therapy in resected non-small cell lung cancer with pathological N2 disease

George Rodrigues

Abstract

An impressive clinical trial record exists in the investigation of the clinical benefits and risks related to the utilization of post-operative radiation therapy (PORT) in resected localized and locally-advanced non-small cell lung cancer (NSCLC). These trials generally demonstrated that local control can be improved with the application of PORT; however, the impact on overall survival was less certain. In response to this uncertainty, the PORT Meta-analysis Trialists Group published an individual patient meta-analysis on this important topic in 1998 (1). This report identified a statistically significant reduction in survival with the application of PORT to all nodal (N0–N2) groups. In the most recent update of the meta-analysis, PORT was associated with an 18% relative increase in the risk of death (i.e., hazard ratio: 1.18) (2).

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