Postoperative radiotherapy in localized non-small cell lung cancer

Surgery alone can cure 40-85% of patients with localized non-small cell lun g cancer, depending on tumor stage and metastastic lymph-node involvement. As local failure rates occur in up to 50%. of the cases, postoperative radi otherapy as an adjuvant treatment option has been evaluated in several tria ls. This review brielfly summarizes the published data mainly from randomiz ed trials. While most of the studies showed a decrease in local recurrence rate, especially in stage-III/N2 tumors after postoperative radiotherapy, n o impact could be shown on overall survival. In early stages a detrimental effect of postoperative radiotherapy has been postulated, but those finding s have to be interpreted with caution as radiation techniques used were sub optimal and probably not today's state of the art. A carefully designed ran domized trial using modern radiotherapy techniques is warrented to define t he impact of irradiation on completely resected NSCLC. (C) 2001 Published b y Elsevier Science Ireland Ltd.