A randomized clinical trial of postoperative radiotherapy of the patients with non-small cell lung cancer after radical surgery

Abstract

Objective　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.Conclusion　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).


DOI: 10.3779/j.issn.1009-3419.2000.05.03