Postoperative Radiotherapy for Pathologic N2 Non-Small-Cell Lung Cancer Treated with Adjuvant Chemotherapy: A Review of the National Cancer Data Base

A review of the National Cancer Data Base was undertaken to determine the impact of postoperative radiation therapy on survival for patients with pathologic stage IIIA NSCLC in the setting of adjuvant chemotherapy. The authors point out that some prior analyses demonstrated a decrease in survival with postoperative radiation therapy likely due to the inclusion of patients with N0 or N1 disease and toxicity associated with outdated radiation treatment regimens. The main results of this study were that in patients with completely resected stage IIIA NSCLC, there was an improvement in median overall survival and 5-year overall survival with postoperative radiation therapy (45.2 months and 39.3%) over adjuvant chemotherapy alone (40.7 months and 34.8%). Furthermore, when other factors associated with overall survival were controlled for, the survival benefit of postoperative radiation therapy, although modest, continued to be significant.