RESULTS For patients who have undergone surgical resection , high-level evidence suggests that use of postoperative RT does not influence survival , but optimizes local control for patients with N2 involvement , and its use in the setting of positive margins or gross primary /nodal residual disease is recommended .
No high-level evidence exists for the routine use of preoperative induction chemoradiation therapy ; however , modern surgical series and a post-hoc Intergroup 0139 clinical trial analysis suggest that a survival benefit may exist if patients are properly selected and surgical techniques/postoperative care is optimized .
PURPOSE To provide guidance to physicians and patients with regard to the use of adjuvant external beam radiation therapy ( RT ) in locally advanced non-small cell lung cancer ( LA NSCLC ) based on available medical evidence complemented by consensus-based expert opinion .
Postoperative radiotherapy for radically resected N2 non-small-cell lung cancer (NSCLC): randomised clinical study 1988-1992.
In the period 1988 - 1992 , 74 consecutive radically resected patients with NSCLC were r and omised to postoperative radiotherapy or surgery alone in order to evaluate the influence of postoperative radiotherapy on survival . There were 61 males and 13 females , aged 35 - 80 years , median 59 years . Their distribution by stage was as follows : pT1N2 = 19 , pT2N2 = 54 , pT3N2 = one patient ; histology : 32 squamous , 32 adeno and 10 large cell carcinomas ; surgery : atypical resection in six , lobectomy in 27 , bilobectomy in ten , and pneumonectomy in 31 patients . In 27 patients , only one lymph node in a single mediastinal lymph node site was affected ; in 31 patients more than one lymph node in one site ; in 16 patients more sites were affected . In 35/74 patients radiotherapy of hilar and mediastinal sites with 3000 cGy in 2 weeks was performed . On December 31 , 1994 , 19 patients ( 26 % ) were still alive ; 39/55 patients died of the following causes : locoregional failure-10(26 % ) , distant metastases- 25 ( 64 % ) , other tumor-unrelated causes-four patients ( 10 % ) . Five-year survival rates did not show statistically significant differences between the irradiated and surgically treated patients only with respect to sex , pTNM stage , histology and frequency of locoregional failure . The number of metastatic mediastinal lymph nodes was the only significant prognostic factor ( P < 0.005 ) in both r and omised groups
RESULTS For patients who have undergone surgical resection , high-level evidence suggests that use of postoperative RT does not influence survival , but optimizes local control for patients with N2 involvement , and its use in the setting of positive margins or gross primary /nodal residual disease is recommended .
No high-level evidence exists for the routine use of preoperative induction chemoradiation therapy ; however , modern surgical series and a post-hoc Intergroup 0139 clinical trial analysis suggest that a survival benefit may exist if patients are properly selected and surgical techniques/postoperative care is optimized .
PURPOSE To provide guidance to physicians and patients with regard to the use of adjuvant external beam radiation therapy ( RT ) in locally advanced non-small cell lung cancer ( LA NSCLC ) based on available medical evidence complemented by consensus-based expert opinion .