Postoperative radiation therapy in non-small cell lung cancer

Postoperative Radiation Therapy for Patients Who Have Resected Non–Small Cell Lung Cancer

“…The role of adjuvant RT for patients who have resected early stage NSCLC remains ill-defined [68][69][70][71][72]. Although a modest survival gain might not have been detectable in the small trials that have conducted to date, it is likely that the high frequency of systemic disease in patients who have positive nodes mandates effective systemic and local adjuvant strategies.…”

Coping with the unexpected at surgery

“…Typically, adjuvant RT is given after an R1 resection, primarily based on rationale with only scant data (5-year survival is 20-40% with adjuvant RT [16,17] vs 15-25% without adjuvant RT [18,19], comparing several small series). Much stronger data from randomized trials support chemoradiotherapy versus RT alone after an R1 resection [20,21].…”

Postoperative Adjuvant Therapy for Patients With Resected Non-Small Cell Lung Cancer: Still Controversial After all These Years

“…One surgical review indicated a poorer prognosis for patients with ECE than intranodal disease, but this has not been well studied in the context of adjuvant mediastinal irradiation. 10,11 Postoperative Radiation Therapy Several older retrospective series claimed that postoperative irradiation of mediastinal and hilar nodes improved survival in patients with resected NSCLC, particularly if they had nodal metastases. 12,13 This issue has been investigated in several prospective trials that, although methodologically flawed, provide a consensus answer that overall survival is minimally (if at all) improved, but local failure is probably reduced with such treatment.…”