ⅢA(N_2)期非小细胞肺癌根治术后辅助放疗研究进展

Advances in Postoperative Radiotherapy After Curative Resection with Pathological Stage ⅢA(N_2) Non-small Cell Lung Cancer

病理分期为N_2的ⅢA期非小细胞肺癌(NSCLC)异质性强,生存差异明显。术后放疗在其综合治疗中的地位仍不明确。二维时代的研究显示术后放疗对生存无获益,但随着放疗设备和技术的不断改进,术后辅助放疗在ⅢA(N_2)期NSCLC中的价值需要重新评估。现有大规模的回顾性分析提示采用现代放疗技术和适当的放疗剂量对pN_2患者有生存获益,但目前仍缺乏高级别证据的前瞻性研究。

Pathological stage ⅢA（N2） non-small cell lung cancer（NSCLC） have strong heterogeneity and significant survival differences. The role of postoperative radiotherapy（PORT） in its integrated treatment strategy is still unclear. Studies showed that PORT had no survival benefit in two-dimensional era of radiotherapy. However,with the improvement of radiotherapy equipment and technology,the value of PORT in ⅢA（N2） NSCLC patients is worthy to be reassessed. Large-scale retrospective studies have suggested that there is benefit on survival using modern radiation techniques and proper radiation dose for patients with pN2,but still lacking of prospective studies of high-level evidence.