Impact of Radiation on Survival After Complete Resection of Non-Small Cell Lung Cancer: Descriptive Analysis in the Randomized Adjuvant Chemotherapy Trial Anita 1
This analysis was done on a study designed to look at the benefit of chemotherapy for early stage lung cancers. The researchers have analyzed the use of radiation therapy in the patients enrolled on this study. The patients were randomized to receive chemotherapy or not, so some patients received radiation and chemotherapy, some chemotherapy alone or radiation alone.
The analysis found that patients who had no cancer detected in the lymph nodes (N0), had worse 5-year survival when they received radiation therapy, regardless of whether or not they also received chemotherapy. This is not surprising, as these patients have the lowest risk of local nodal recurrence, and thus stand to gain the least benefit from local treatment. For patients with N1 nodal involvement, on the other hand, radiation alone improved 5-year survival, although the combination of radiation and chemotherapy resulted in a worse survival. Finally, patients with N2 nodal involvement have improved 5-year survival in both the radiation alone and combination therapy groups.
Caution must be used in interpreting these results because patients were not randomized to receive radiation or not. A randomized study is ongoing to better evaluate the use of radiation therapy in early stage lung cancers.