Should patients with post-resection locoregional recurrence of lung cancer receive aggressive therapy?

Walter J. Curran, Scott H. Herbert, Patrick M. Stafford, Howard M. Sandler, Seth A. Rosenthal, W. Gillies McKenna, Edward hughes, Michael J. Dougherty, Steven Keller

Research output: Contribution to journalArticle

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Abstract

The outcome of thirty-seven patients with a post-resection locoregional recurrence of non-small cell lung cancer treated with radiation therapy alone between 1979 and 1989 was compared to that of 759 patients with unresected non-small cell lung cancer also treated with standard radiation during the same period. Each patient's locoregional recurrence was staged using the current American Joint Committee on Cancer staging system. Comparison of pretreatment characteristics between the two groups, including age, sex, extent of weight loss, performance status, stage, and histologic subtype revealed fewer patients with > 5% weight loss (35 vs. 47%, p = 0.04) and more cases with squamous histology (54 vs. 28%, p = 0.01) among the patients with locoregional recurrences than those with newly diagnosed lesions. Over 80% of both groups had clinical stage III lesions. The median radiation doses were 56 and 59 Gy for recurrent and newly diagnosed cases (p = NS). For the patients with locoregional recurrences, the median time from resection to recurrence was 13 months (range: 3-118 months), and the recurrences were predominantly nodal in 25 cases, chest wall/pleural in four and at the bronchial stump in eight. When measured from the date of documented recurrence, the median survival time and 2-year actuarial survival rate of the patients with recurrent lesions were 12 months and 22%, as compared to 12 months and 26% for the newly diagnosed patients (p = NS). Freedom from documented locoregional tumor progression at 2 years was 30% for both groups. Patients with bronchial stump lesions had superior survival to those with nodal or chest wall recurrences, with a median survival time of 36 versus 9 months. A therapeutic approach to selected patients with post-resection locoregional recurrence of non-small cell lung cancer equally aggressive to that for newly diagnosed lung cancer patients is justified by these results, especially for patients with bronchial stump recurrences.

Original languageEnglish (US)
Pages (from-to)25-30
Number of pages6
JournalInternational Journal of Radiation Oncology, Biology, Physics
Volume24
Issue number1
DOIs
StatePublished - 1992
Externally publishedYes

Fingerprint

lungs
therapy
Lung Neoplasms
cancer
Recurrence
lesions
Therapeutics
Non-Small Cell Lung Carcinoma
chest
Thoracic Wall
Survival
Weight Loss
Radiation
histology
Neoplasm Staging
radiation
progressions
pretreatment
radiation therapy
Histology

Keywords

  • Lung neoplasm
  • Radiotherapy
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Curran, W. J., Herbert, S. H., Stafford, P. M., Sandler, H. M., Rosenthal, S. A., McKenna, W. G., ... Keller, S. (1992). Should patients with post-resection locoregional recurrence of lung cancer receive aggressive therapy? International Journal of Radiation Oncology, Biology, Physics, 24(1), 25-30. https://doi.org/10.1016/0360-3016(92)91016-G

Should patients with post-resection locoregional recurrence of lung cancer receive aggressive therapy? / Curran, Walter J.; Herbert, Scott H.; Stafford, Patrick M.; Sandler, Howard M.; Rosenthal, Seth A.; McKenna, W. Gillies; hughes, Edward; Dougherty, Michael J.; Keller, Steven.

In: International Journal of Radiation Oncology, Biology, Physics, Vol. 24, No. 1, 1992, p. 25-30.

Research output: Contribution to journalArticle

Curran, WJ, Herbert, SH, Stafford, PM, Sandler, HM, Rosenthal, SA, McKenna, WG, hughes, E, Dougherty, MJ & Keller, S 1992, 'Should patients with post-resection locoregional recurrence of lung cancer receive aggressive therapy?', International Journal of Radiation Oncology, Biology, Physics, vol. 24, no. 1, pp. 25-30. https://doi.org/10.1016/0360-3016(92)91016-G
Curran, Walter J. ; Herbert, Scott H. ; Stafford, Patrick M. ; Sandler, Howard M. ; Rosenthal, Seth A. ; McKenna, W. Gillies ; hughes, Edward ; Dougherty, Michael J. ; Keller, Steven. / Should patients with post-resection locoregional recurrence of lung cancer receive aggressive therapy?. In: International Journal of Radiation Oncology, Biology, Physics. 1992 ; Vol. 24, No. 1. pp. 25-30.
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abstract = "The outcome of thirty-seven patients with a post-resection locoregional recurrence of non-small cell lung cancer treated with radiation therapy alone between 1979 and 1989 was compared to that of 759 patients with unresected non-small cell lung cancer also treated with standard radiation during the same period. Each patient's locoregional recurrence was staged using the current American Joint Committee on Cancer staging system. Comparison of pretreatment characteristics between the two groups, including age, sex, extent of weight loss, performance status, stage, and histologic subtype revealed fewer patients with > 5{\%} weight loss (35 vs. 47{\%}, p = 0.04) and more cases with squamous histology (54 vs. 28{\%}, p = 0.01) among the patients with locoregional recurrences than those with newly diagnosed lesions. Over 80{\%} of both groups had clinical stage III lesions. The median radiation doses were 56 and 59 Gy for recurrent and newly diagnosed cases (p = NS). For the patients with locoregional recurrences, the median time from resection to recurrence was 13 months (range: 3-118 months), and the recurrences were predominantly nodal in 25 cases, chest wall/pleural in four and at the bronchial stump in eight. When measured from the date of documented recurrence, the median survival time and 2-year actuarial survival rate of the patients with recurrent lesions were 12 months and 22{\%}, as compared to 12 months and 26{\%} for the newly diagnosed patients (p = NS). Freedom from documented locoregional tumor progression at 2 years was 30{\%} for both groups. Patients with bronchial stump lesions had superior survival to those with nodal or chest wall recurrences, with a median survival time of 36 versus 9 months. A therapeutic approach to selected patients with post-resection locoregional recurrence of non-small cell lung cancer equally aggressive to that for newly diagnosed lung cancer patients is justified by these results, especially for patients with bronchial stump recurrences.",
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