Impact of induction chemoradiotherapy on pulmonary function after lobectomy for lung cancer Hiroaki Nomori, MD, Atsushi Shiraishi, MD, Yue Cong, MD,

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Impact of induction chemoradiotherapy on pulmonary function after lobectomy for lung cancer Hiroaki Nomori, MD, Atsushi Shiraishi, MD, Yue Cong, MD, Kazufusa Shoji, MD, Masafumi Misawa, MD, Hiroshi Sugimura, MD, Yu Oyama, MD The Journal of Thoracic and Cardiovascular Surgery Volume 155, Issue 5, Pages 2129-2137.e1 (May 2018) DOI: 10.1016/j.jtcvs.2017.12.081 Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Patient algorithm used in the study. ICRT, Induction chemoradiotherapy. The Journal of Thoracic and Cardiovascular Surgery 2018 155, 2129-2137.e1DOI: (10.1016/j.jtcvs.2017.12.081) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Percentages of postoperative versus preoperative whole-lung function in the induction chemoradiotherapy (ICRT) and non-ICRT groups. The postoperative change of whole-lung function, evaluated from the formula %FEV1 in PFT after surgery/%FEV1 before surgery. Red indicates the postoperative change of whole-lung function in ICRT group, and blue indicates the postoperative change of whole-lung function in non-ICRT group. The Journal of Thoracic and Cardiovascular Surgery 2018 155, 2129-2137.e1DOI: (10.1016/j.jtcvs.2017.12.081) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Δ% forced expiratory volume in 1 second (FEV1) of the ipsilateral preserved lobe after surgery in the induction chemoradiotherapy (ICRT) and non-ICRT groups. The postoperative change of whole-lung function, evaluated from the formula %FEV1 in PFT after surgery/%FEV1 before surgery. Red indicates the postoperative change of whole-lung function in ICRT group, and blue indicates the postoperative change of whole-lung function in non-ICRT group. The Journal of Thoracic and Cardiovascular Surgery 2018 155, 2129-2137.e1DOI: (10.1016/j.jtcvs.2017.12.081) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Preoperative and postoperative percentage of forced expiratory volume in 1 second (FEV1) values of the contralateral lung in the induction chemoradiotherapy (ICRT) and non-ICRT groups. The Journal of Thoracic and Cardiovascular Surgery 2018 155, 2129-2137.e1DOI: (10.1016/j.jtcvs.2017.12.081) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Δ% forced expiratory volume in 1 second (FEV1) of the contralateral lung after surgery in the induction chemoradiotherapy (ICRT) and non-ICRT groups. The postoperative change of whole-lung function, evaluated from the formula %FEV1 in PFT after surgery/%FEV1 before surgery. Red indicates the postoperative change of whole-lung function in ICRT group, and blue indicates the postoperative change of whole-lung function in non-ICRT group. The Journal of Thoracic and Cardiovascular Surgery 2018 155, 2129-2137.e1DOI: (10.1016/j.jtcvs.2017.12.081) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Sensitivity analyses for potential confounders. Intergroup comparison of the primary outcome after propensity score matching (original model) was further adjusted for each potential confounder (model B-I) and all potential confounders (model J). Estimates are shown in mean difference with 95% confidence intervals. %FEV1, Percentage of predicted forced expiratory volume in 1 second. The Journal of Thoracic and Cardiovascular Surgery 2018 155, 2129-2137.e1DOI: (10.1016/j.jtcvs.2017.12.081) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Absolute standardized mean differences between the control group and chemoradiotherapy group before and after matching. FEV1, Forced expiratory volume in 1 second; FVC, forced vital capacity. The Journal of Thoracic and Cardiovascular Surgery 2018 155, 2129-2137.e1DOI: (10.1016/j.jtcvs.2017.12.081) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 Distribution of the propensity score in the induction chemoradiotherapy (ICRT) as well as the non-ICRT groups before and after matching is shown as a histogram per 5% propensity score steps; white bars, before the matching; red bars, after the matching. The Journal of Thoracic and Cardiovascular Surgery 2018 155, 2129-2137.e1DOI: (10.1016/j.jtcvs.2017.12.081) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

The field received 20 Gy or more (purple line) for left upper lobe cT2aN2M0 cancer. The Journal of Thoracic and Cardiovascular Surgery 2018 155, 2129-2137.e1DOI: (10.1016/j.jtcvs.2017.12.081) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Video 1 Left upper lobectomy after induction chemoradiotherapy. Video available at: http://www.jtcvsonline.org/article/S0022-5223(17)33059-3/fulltext. The Journal of Thoracic and Cardiovascular Surgery 2018 155, 2129-2137.e1DOI: (10.1016/j.jtcvs.2017.12.081) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions