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 .
Effects of postoperative mediastinal radiation on completely resected stage II and stage III epidermoid cancer of the lung.
We r and omly assigned 230 patients with resected Stage II or III epidermoid ( squamous-cell ) lung cancer to receive postoperative adjuvant radiotherapy or no adjuvant treatment . Careful intraoperative staging had been performed in all patients . Before r and omization , patients were stratified according to stage , weight loss , age , and institution . Prognostic variables , such as stage , weight loss , age , nodal-disease status , and tumor status , were equally distributed between the two groups . The mean time from r and omization to analysis was 3.5 years among the 210 eligible patients . There was no evidence that radiotherapy improved survival , and although recurrence rates appeared to be somewhat reduced among patients assigned to radiotherapy , these decreases were not statistically significant . However , radiotherapy did produce a striking and significant reduction in recurrences to the ipsilateral lung and mediastinum . Moreover , overall recurrence rates were reduced by radiotherapy in patients with N2 disease ( P less than 0.05 ) , although even this subgroup had no evidence of improved survival . We conclude that radiotherapy can reduce local recurrences after resection of epidermoid carcinoma of the lung , but that it does not increase survival rates
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 .