Postoperative radiotherapy in resected N2 non-small-cell lung cancer: Lung ART
Mené entre 2007 et 2018 sur 501 patients atteints d'un cancer du poumon non à petites cellules (durée médiane de suivi : 4,8 ans), cet essai randomisé international de phase III évalue la supériorité, du point de vue de la survie sans maladie, d'un traitement comportant une radiothérapie postopératoire médiastinale par rapport à un traitement sans radiothérapie postopératoire
For more than 20 years, the role of postoperative radiotherapy (PORT) has been controversial in patients with completely resected (R0) N2 non-small-cell lung cancer (NSCLC), because no contemporary clinical trials with adequate staging and treatment were available. The results of the randomised, open-label, phase 3, Lung Adjuvant Radiotherapy Trial (Lung ART) superiority trial reported in The Lancet Oncology by Cecile Le Pechoux and colleagues were therefore eagerly awaited. In this multicentre, international, academic-led trial, which took almost 11 years to complete enrolment, 501 patients with pathologyproven, completely resected N2 disease were enrolled and randomly assigned (1:1) to receive PORT (n=252)
or to the control group (no PORT; n=249). Of note, almost all (91%) patients were ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG)-PET staged, all patients had baseline brain imaging, and 96% received neoadjuvant or adjuvant chemotherapy. PORT was administered with threedimensional (3D) conformal radiotherapy (89%) or intensity modulated radiotherapy (11%). The study team has to be congratulated for completing this challenging trial.
The Lancet Oncology , commentaire en libre accès, 2020