Impact of postoperative radiation therapy on survival in patients with complete resection and Stage I, II, or IIIA non-small-cell lung cancer treated with adjuvant chemotherapy: The Adjuvant Navelbine International Trialist Association (ANITA) randomized trial
Impact of postoperative radiation therapy on survival in patients with complete resection and Stage I, II, or IIIA non-small-cell lung cancer treated with adjuvant chemotherapy: The Adjuvant Navelbine International Trialist Association (ANITA) randomized trial
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DOI：
10.1016/j.ijrobp.2008.01.044
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发表时间：
2008-11-01
影响因子：
7
通讯作者：
Mahe, Marc-Andre
中科院分区：
文献类型：
--
作者：
Douillard, Jean-Yves;Rosell, Rafael;Mahe, Marc-Andre
目的：研究术后放疗（PORT）对生存的影响，在辅助诺维本国际试验协会（ANITA）的随机研究辅助chemotherapy.Methods和Materials：ANITA是一项随机试验的辅助顺铂和长春瑞滨化疗与观察完全切除的非小细胞肺癌（NSCLC）阶段IB至IIIA。PORT被推荐用于pN+疾病，但不是随机或强制性的。每家临床试验机构在研究开始前决定是否使用PORT。我们在这里描述了ANITA的每个治疗组中有和没有PORT的患者的生存率。由于这是一项计划外的亚组分析，因此没有进行生存率的统计学比较。结果：总体而言，840例患者中有232例接受了PORT（观察组33.3%，化疗组21.6%）。在单变量分析中，PORT对总体人群生存率有不利影响。观察组中pN1疾病患者的生存期因PORT而得到改善（中位生存期[MS] 25.9 vs. 50.2个月），而PORT对化疗组有不利影响（MS 93.6个月和46.6个月）。相比之下，生存改善pN2疾病的患者接受PORT，无论是在化疗（MS 23.8与47.4个月）和观察组（中位数12.7与22.7个月）。结论：这项回顾性评价表明一个积极的影响PORT在pN2疾病和pN1疾病时，患者接受辅助化疗的负面影响。结果支持在完全切除的pN2 NSCLC中进行的前瞻性随机研究中进一步评价PORT。(C)2008年爱思唯尔公司
Purpose: To study the impact of postoperative radiation therapy (PORT) on survival in the Adjuvant Navelbine International Trialist Association (ANITA) randomized study of adjuvant chemotherapy.Methods and Materials: ANITA is a randomized trial of adjuvant cisplatin and vinorelbine chemotherapy vs. observation in completely resected non-small-cell lung carcinoma (NSCLC) Stages IB to IIIA. Use of PORT was recommended for pN+ disease but was not randomized or mandatory. Each center decided whether to use PORT before initiation of the study. We describe here the survival of patients with and without PORT within each treatment group of ANITA. No statistical comparison of survival was performed because this was an unplanned subgroup analysis.Results: Overall, 232 of 840 patients received PORT (33.3% in the observation arm and 21.6% in the chemotherpy arm). In univariate analysis, PORT had a deleterious effect on the overall population survival. Patients with pN1 disease had an improved survival from PORT in the observation arm (median survival [MS] 25.9 vs. 50.2 months), whereas PORT had a detrimental effect in the chemotherapy group (MS 93.6 months and 46.6 months). In contrast, survival was improved in patients with pN2 disease who received PORT, both in the chemotherapy (MS 23.8 vs. 47.4 months) and observation arm (median 12.7 vs. 22.7 months).Conclusion: This retrospective evaluation suggests a positive effect of PORT in pN2 disease and a negative effect on pN1 disease when patients received adjuvant chemotherapy. The results support further evaluation of PORT in prospectively randomized studies in completely resected pN2 NSCLC. (C) 2008 Elsevier Inc.