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目的:初步探讨侵犯胸壁的非小细胞肺癌(NSCLC)治疗失败模式及术后放疗价值。方法:收集2010—2018年在中国医学科学院肿瘤医院行胸外科手术且病理诊断侵及胸壁的NSCLC Tn 3期患者69例。采用倾向评分配比分析术后放疗组与无放疗组结果。n Kaplan-n Meier生存分析和n Cox模型预后因素分析。n 结果:全组中位总生存期为25个月，中位无进展生存期为8个月。全组首诊Mn 0期36例(43%)，其中Rn 0切除28例(78%)，首诊Mn 1a期33例(48%)，均为胸膜转移无法Rn 0切除。53例(77%)进展，26例(38%)局部复发，其中纵隔淋巴结复发占58%，胸壁瘤床复发占36%；远处转移50例(73%)，其中43%为胸膜转移。单因素分析示年龄、病理分期、原发灶侵犯范围、术后是否放疗、术后是否靶向治疗与总生存相关(均n P0.05)。n 结论:对于胸壁受侵的NSCLC，远处转移失败为主，局部失败以纵隔淋巴结、胸壁复发为主，术后放疗可能提高生存，术后综合治疗方式、获益程度还需前瞻性研究进一步证实。“,”Objective::To preliminarily investigate the values of failure mode and postoperative radiotherapy in non-small cell lung cancer (NSCLC) patients with chest wall invasion.Methods:A total of 69 Tn 3 stage NSCLC patients who underwent thoracic surgery in our hospital from 2010 to 2018 and presented with postoperative pathological findings of chest wall invasion were recruited. The outcomes between the post-operative radiotherapy and non-radiotherapy groups were assessed by propsensity matching analysis. n Kaplan-n Meier survival analysis and n Cox’s model prognostic factors analysis were performed.n Results:The median survival time of 69 patients was 25 months and the median progression-free survival was 8 months. Thirty-six cases were diagnosed with primary stage Mn 0 including 28 cases (78%) of Rn 0 resection and 33 cases (48%) were diagnosed with stage Mn 1a and received non-Rn 0 resection because of pleural metastases. In total, 53 cases (77%) suffered from disease progression, and 26 cases (38%) experienced local recurrence including 58% of mediastinal lymph node recurrence and 36% of chest wall tumor bed recurrence. Distant metastases were observed in 50 cases (73%) including 43% of pleural metastases. Univariate analysis showed that age, pathological staging, range of primary lesion invasion, postoperative radiotherapy and postoperative targeted therapy were significantly associated with overall survival (all n P0.05).n Conclusions:For NSCLC patients with chest wall invasion, distal metastasis failure is the main cause, while local failure mainly consists of mediastinal lymph node and chest wall recurrence. Postoperative radiotherapy may improve survival. Nevertheless, the combination and benefit degree of postoperative comprehensive treatment need to be further confirmed by prospective studies.