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Published on: February 27, 2026
254
Postoperative radiotherapy for non-small cell lung cancer
Sarah Burdett1, Larysa Rydzewska, Jayne Tierney
1Meta-analysis Group, MRC Clinical Trials Unit at UCL, Aviation House, 125 Kingsway, London, UK, WC2B 6NH.
The Cochrane Database of Systematic Reviews
|September 30, 2016
Summary
Postoperative radiotherapy (PORT) is detrimental to patients with completely resected non-small cell lung cancer (NSCLC), increasing the risk of death by 18%. PORT should not be routinely used in NSCLC treatment.
Area of Science:
- Oncology
- Radiotherapy
- Thoracic Surgery
Background:
- The efficacy of postoperative radiotherapy (PORT) for completely resected non-small cell lung cancer (NSCLC) remains uncertain.
- A systematic review and individual participant data meta-analysis of randomized controlled trials (RCTs) was conducted to clarify PORT's role.
Purpose of the Study:
- To evaluate the impact of PORT on survival and recurrence in completely resected NSCLC patients.
- To determine if specific patient subgroups experience different outcomes with PORT.
Main Methods:
- A comprehensive literature search of multiple databases and trial registers was performed.
- Individual participant data (IPD) from 11 RCTs involving 2343 patients were analyzed.
- Intention-to-treat analyses were used to assess survival endpoints.
Main Results:
- PORT was associated with a significant adverse effect on survival, increasing the risk of death by 18% (Hazard Ratio: 1.18).
- This translates to an absolute 5% detriment in overall survival at two years (58% vs. 53%).
- Subgroup analyses did not reveal differential effects of PORT across various patient characteristics.
Conclusions:
- The findings indicate that PORT is detrimental for patients with completely resected NSCLC and should not be part of routine treatment.
- Ongoing RCTs are needed to evaluate the effects of modern radiotherapy techniques, particularly for patients with N2 tumors.
