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Postoperative radiotherapy for ypN2 non-small cell lung cancer after neoadjuvant chemotherapy and surgery warrants further evaluation

  • Yongxing Bao
    Affiliations
    Department of VIP Medical Services & Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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  • Zhouguang Hui
    Correspondence
    Corresponding author at: Department of Radiation Oncology, Department of VIP Medical Services, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Panjiayuan Nanli #17, Chaoyang District, Beijing 100021, China.
    Affiliations
    Department of VIP Medical Services & Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
    Search for articles by this author
Published:November 02, 2022DOI:https://doi.org/10.1016/j.radonc.2022.10.032
      Komiya and colleagues’ study showed the survival benefit of postoperative radiotherapy (PORT) in patients with ypN2 non-small cell lung cancer after neoadjuvant chemotherapy and surgery through the National Cancer Database (NCDB) [
      • Komiya T.
      • Takamori S.
      • Wilding G.
      Adjuvant radiation therapy improves survival in stage IIIA (N2) non-small cell lung cancer with persistent N2 disease after neoadjuvant chemotherapy.
      ]. The results are of great significance for exploring the indication of PORT for N2 non-small cell lung cancer. Compared with pN2, patients with ypN2 might face more regional tumour burden and higher risk of systematic therapy resistance, which may theoretically benefit more from PORT.
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      References

        • Komiya T.
        • Takamori S.
        • Wilding G.
        Adjuvant radiation therapy improves survival in stage IIIA (N2) non-small cell lung cancer with persistent N2 disease after neoadjuvant chemotherapy.
        Radiother Oncol. 2022; https://doi.org/10.1016/j.radonc.2022.07.018
        • Le Pechoux C.
        • et al.
        Postoperative radiotherapy versus no postoperative radiotherapy in patients with completely resected non-small-cell lung cancer and proven mediastinal N2 involvement (Lung ART): an open-label, randomised, phase 3 trial.
        Lancet Oncol. 2022; 23: 104-114https://doi.org/10.1016/s1470-2045(21)00606-9
        • Shinde A.
        • et al.
        Optimal adjuvant therapy in clinically N2 non-small cell lung cancer patients undergoing neoadjuvant chemotherapy and surgery: The importance of pathological response and lymph node ratio.
        Lung Cancer. 2019; 133: 136-143https://doi.org/10.1016/j.lungcan.2019.05.020
        • Bao Y.
        • et al.
        Postoperative radiotherapy improves survival of patients with ypN2 non-small cell lung cancer after neoadjuvant chemotherapy followed by surgery - A propensity score matching study of the Surveillance, Epidemiology, and End Results database.
        Thorac Cancer. 2022; 13: 404-411https://doi.org/10.1111/1759-7714.14273
        • Brandt W.S.
        • et al.
        Postoperative Radiotherapy for Surgically Resected ypN2 Non-Small Cell Lung Cancer.
        Ann Thorac Surg. 2018; 106: 848-855https://doi.org/10.1016/j.athoracsur.2018.04.064

      Linked Article

      • Response to Bao et al
        Radiotherapy and Oncology
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          We appreciate Bao et al. for their interest on our recently reported retrospective study regarding the use of postoperative radiotherapy (PORT) in patients with persistent N2 non-small cell lung cancer after neoadjuvant chemotherapy [1,2]. The role of PORT has been one of the controversial subjects in thoracic oncology for decades. Although the recent prospective phase III trials demonstrated lack of survival benefit in overall N2 population, the subgroup analysis of patients who have undergone neoadjuvant chemotherapy had a significantly longer disease-free survival in those with PORT [3,4].
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