Role of Postoperative Radiation Therapy in Non-Small Cell Lung Cancer
Patients who undergo surgery for non-small cell lung cancer are at relatively high risk of local/regional recurrence, especially those with involved mediastinal lymph nodes. Postoperative radiation therapy (PORT) has been shown to decrease the risk of local/regional recurrence but its effect on overall survival remains unclear due to the competing risks of distant metastases and treatment-related morbidity and mortality. The randomized LungART study sought to examine the benefit of PORT, using modern techniques and doses, in patients with mediastinal lymph node involvement (N2) receiving adjuvant chemotherapy. Preliminary results show an improvement in local/regional control but no improvement in overall survival. While many guidelines continue to recommend PORT in the setting of positive margins or mediastinal lymph node involvement, these recommendations may change based on the final results of the LungART trial.
