Effects of postoperative adjuvant radiotherapy on stage IIIA-N2 non-small cell lung cancer and prognostic analysis

Purpose: We aimed to explore the efficacy and safety of postoperative adjuvant radiotherapy in the treatment of non-small cell lung cancer (NSCLC) (stage IIIA-N2), and to analyze the influencing factors for the prognosis of patients. Methods: A total of 142 patients with NSCLC (stage IIIAN2) were collected for retrospective analysis. Postoperative adjuvant radiotherapy was performed in 71 cases (Radiotherapy group), while it was not conducted in the remaining 71 cases (Control group). The survival status of patients was recorded during follow-up. Moreover, the possible influencing factors for the prognosis of patients were analyzed. Results: The median survival time was 34.7 +/- 5.4 months and 31.9 +/- 4.9 months, the 5-year overall survival (OS) rate was 32.4% and 26.8%, and the 5-year progression-free survival (PFS) rate was 25.4% and 12.7%, respectively, in the Radiotherapy group and the Control group. The 5-year OS was significantly correlated with smoking history, tumor T stage, ratio of positive lymph nodes, number of cycles of post-operative chemotherapy, and whether postoperative adjuvant radiotherapy was combined. Moreover, tumor T stage, ratio of positive lymph nodes and whether adjuvant radiotherapy was combined were independent influencing factors for post- operative OS of patients. The lower tumor T stage, lower ratio of positive lymph nodes and adjuvant radiotherapy combined corresponded to the higher OS rate. Conclusions: Postoperative adjuvant radiotherapy is safe and feasible in the treatment of NSCLC (stage IIIA-N2), which can increase the survival of patients and the local control rate of tumors. Patients with a lower tumor T stage and a lower ratio of positive lymph nodes have higher sur- vival rates.