Postoperative Intensity-Modulated Radiation Therapy Impacts Patient Outcomes

A retrospective cohort study using data from the National Cancer Database from January 2004 to December 2019 examined trends in postoperative intensity modulated radiation therapy (IMRT) and the impacts on patient outcomes. Researchers found that, compared to 3D conformal radiation therapy (3DCRT), IMRT improved outcomes for non-small cell lung cancer (NSCLC) patients with tumors that could not be fully resected.

Before this study, it was accepted that postoperative radiation therapy (PORT) improved patient survival. However, there was little information on how different forms of PORT compared.

According to the Memorial Sloan Kettering Cancer Center, IMRT “is a type of cancer treatment that uses advanced computer programs to calculate and deliver radiation directly to cancer cells from different angles. It allows people with cancer to receive higher, more effective doses of radiation while limiting damage to the healthy tissues and organs around it. This increases your chance of a cure and lessens the likelihood of side effects.”

Of the 4483 patients included in this study, 47.2% had 3DCRT and 52.8% had IMRT. Researchers found that the percentage of patients receiving IMRT increased nearly five-fold between 2004 and 2019, from 14.3% to 70.7%.

In addition to the upward trend of IMRT use, researchers in this study found that those receiving IMRT as PORT had better overall survival, with a five year overall survival rate of 38.2%. Those undergoing 3DCRT had a slightly lower five year overall survival rate at 31.9%.

“In this cohort study, use of IMRT for PORT among patients with incompletely resected NSCLC increased in the US from 2004 to 2019 and was associated with improved survival outcomes compared with 3DCRT. Further studies are warranted to investigate the role of IMRT for PORT,” concluded investigators in the publication.

Understanding the impacts of different kinds of PORT can help clinicians improve their patients’ odds of survival. Despite the information shared in this publication, additional research must be conducted to analyze the long-term survival rates. Clinicians are urged to use their prior knowledge of radiation therapy and the patient’s history alongside this research when making medical decisions.