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Among older patients who undergo surgery for locally advanced, non-small-cell lung cancer, many receive postoperative radiation therapy. The radiation therapy, however, may not improve treatment outcomes. These results were published in Cancer.

Lung cancer remains the leading cause of cancer death in theUnited States. Non–small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers.

Treatment of NSCLC may involve surgery, chemotherapy, targeted therapy, radiation therapy, or some combination of these approaches.

The current study explored the treatment of older patients with Stage III NSCLC that had spread to certain lymph nodes (N2). After surgery to treat this stage of lung cancer, some patients may also receive radiation therapy in an effort to reduce the risk of cancer recurrence. There has been no clear evidence, however, that routine postoperative radiation therapy provides a benefit for these patients.

To examine the use of postoperative radiation therapy in older patients with Stage III, N2 NSCLC, researchers collected information from a largeUScancer registry and Medicare records. Information was available about 1,307 patients.

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  • More than half (54 percent) received postoperative radiation therapy.
  • People who received radiation therapy did not have better survival than people who did not receive radiation therapy.

Because this was not a randomized clinical trial, the results are not definitive. Nevertheless, the results suggest that that many older lung cancer patients are receiving a treatment (postoperative radiation therapy) that may not provide a benefit and that comes with side effects and costs. Results from ongoing clinical trials may shed more light on this issue.

Whether similar results would be seen in younger patients or in patients with a different pattern of lymph node involvement is unknown.

Reference: Wisnivesky JP, Halm EA, Bonomi M, Smith C, Mhango G, Bagiella E. Postoperative radiotherapy for elderly patients with stage III lung cancer. Cancer. Early online publication February 13, 2012.

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