Background: To study the value of postoperative radiotherapy of non-small cell lung cancer (NSCLC) with lymph node metastasis (N1 to N2) after radical surgery.
Methods: From February，1982 to December，1995,three hundred and sixty-six patients with NSCLC with N1 or N2 disease were randomized into postoperative radiation group (S+R) and surgery alone group (S alone).Radiation fields covered the ipsilateral hilum and most part of mediastinum.The mid-plane dose was 60Gy/30fx for 6 weeks.One hundred and thirty-four patients in S+R and 162 patients in S alone were available for analysis.Clinical data of the two groups were comparable in both arms,except for the numbers of patient with N2 disease.
Results: The overall 5-year survival rates of S+R group and S alone group were 43.4%±5.1% and 40.5%±4.6%(P=0.56) respectively.The 5-year disease-free survival rates were 42.9%±5.2% in S+R and 38.3%±4.5% in S alone (P=0.28) respectively.The overall 5-year survival rate and 5-year disease-free survival rate of patients with T3-4N1M0 disease were 58.1%±15.5% and 65%±12% in S+R group,and 39.9%±10.2%(P=0.092) and 40%±10%(P=0.057) in S alone.There was less loco-regional recurrence in S+R than in S alone (P<0.01).Distant metastasis was similar in the two groups.
Conclusions: Postoperative radiation has a significant impact in decreasing local relapse,but not in overall survival.However,it may be benefit to those patients with advanced local diseases (T3-4) and early N disease (N1).