"Postoperative radiotherapy in non-small cell

 lung cancer: a meta-analysis using individual patient data from randomised trials"










Executive summary

Aim:  To evaluate the effect of post-operative radiotherapy (PORT) on survival and recurrence in patients with completely resected non-small cell lung cancer.

Methods: Meta-analysis using updated data on individual patients from all available randomised trials. Data on 2128 patients from 9 randomised controlled trials were included (published and unpublished).

Findings:  Overall, the results show a significant adverse effect of PORT on survival with a hazard ratio of 1.21 or 21% relative increase in the risk of death, equivalent to an absolute detriment of 7% at 2 years (95% confidence interval 3 to 11%) reducing overall survival from 55% to 48%. Exploratory subgroup analyses suggests that this detrimental effect was most pronounced for patients with stage I/II, N0-N1 disease, whereas for stage III, N2 patients there was no clear evidence of an adverse effect.

Interpretation:  PORT is detrimental to patients with early stage completely resected non-small cell lung cancer and should not be used in the routine treatment of such patients. The role of PORT in the treatment of N2 tumours is not clear and may warrant further research.


Publications

PORT Meta-analysis Trialists Group. Postoperative radiotherapy in non-small-cell lung cancer: Systematic review and meta-analysis of individual patient data from nine randomised controlled trials. Lancet 1998; 352: 257-63.


 

Further information may be obtained from:

Dr L A Stewart

MRC Cancer Trials Office

222 Euston Road

London   NW1 2DA

UK




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Last updated 22 November 2004
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