UNASSIGNED: A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was: in high-risk @entity1 undergoing sublobar resection for @entity1149 , is brachytherapy effective in reducing local recurrence? Altogether, 60 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, @entity1 group studied, study type, relevant outcomes and results of these papers are tabulated. Three papers are prospective non-randomized studies, two are retrospective and one is a prospective randomized clinical trial. The first prospective non-randomized study included 14 @entity1 treated with sublobar resection plus brachytherapy. No local recurrence was observed. In the second study, 33 @entity1 underwent sublobar resection plus brachytherapy for @entity1149 ( @entity1149 ), of which 10 @entity1 had recurrences. In the third study, 110 @entity1 with Stage IA and IB @entity1149 underwent sublobar resection and brachytherapy, of which 3 local recurrences and 1 combined local and regional recurrence were observed. Two retrospective studies were considered. The first study compared 102 @entity1 undergoing sublobar resection with 101 @entity1 undergoing surgery and brachytherapy. There were 19 recurrences in the surgical resection group (18.6%) and 2 recurrences in the adjuvant brachytherapy arm (2%). In the second study, 214 @entity1 undergoing segmentectomy for Stage I @entity1149 , were compared with 155 @entity1 undergoing segmentectomy plus brachytherapy. Adding brachytherapy did not appear to have an effect on local recurrence in @entity1 undergoing anatomical segmentectomy (4.6 vs 6.4%). In the prospective randomized trial, 108 @entity1 with Stage I @entity1149 were randomized to sublobar resection, and 104 to sublobar resection and brachytherapy. No statistical difference between the two groups was observed in terms of local recurrence. However, in the latter group, 14 @entity1 had a positive staple line, and this group represented the strongest evidence that brachytherapy effectively reduced local recurrence. There may be a role for adjuvant brachytherapy in reducing the local recurrence when sublobar non-anatomical resections are performed and in cases where the surgical margins are compromised. Brachytherapy appears not to affect local control when an anatomical resection is performed with adequate margins.

Is brachytherapy effective for local recurrence control in sublobar resections for XXXX ?

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['NSCLC', 'non-small-cell lung cancer']
@entity1149 :: (MESH:D002289,Disease) :: ['non-small-cell lung cancer']
