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Ann Thorac Surg 2006;81:1926-1936
© 2006 The Society of Thoracic Surgeons

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Review

Postoperative Chemotherapy in Nonsmall Cell Lung Cancer: A Systematic Review

^a Memorial Sloan-Kettering Cancer Center, New York, New York
^b University Health Network, Princess Margaret Hospital and the University of Toronto, Toronto, Ontario, Canada
^c Cancer Care Ontario Program in Evidence-Based Care, McMaster University, Hamilton, Ontario, Canada
^d Juravinski Cancer Centre at Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada

Accepted for publication April 25, 2005.

^_* Address correspondence to Dr Darling, c/o Ms Mackay, Cancer Care Ontario Program in Evidence-Based Care, McMaster University Courthouse T27 Building, 1280 Main St W, Hamilton, ON, L8S 4L8 Canada (Email: mackayj{at}mcmaster.ca).

A systematic review of the evidence for postoperative chemotherapy in completely resected nonsmall cell lung cancer was conducted. Seven meta-analyses and 25 randomized trials met the pre-defined eligibility criteria for the review. The evidence indicates that postoperative platinum-based chemotherapy improves survival compared with surgery alone; for patients with a good performance status who are fit enough for chemotherapy, the survival benefits strongly outweigh the adverse effects of treatment. To date the trials restricted to stage IB or II disease have obtained the greatest survival benefits with postoperative platinum-based chemotherapy. The evidence does not support the use of postoperative radiotherapy with chemotherapy.

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