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目的：评价Ⅲ a (N2)期非小细胞肺癌全切除术后放疗的疗效。方法： 1989年 1月至 1993年 12月，在我院接受根治手术的非小细胞肺癌病人中有 119例无肉眼和镜下残留、病理分期为Ⅲ a(N2)期的非小细胞肺癌，其中 55例接受术后放疗（综合组）， 64例没有放疗（手术组）。综合组病人于术后 28～ 53天开始照射患侧肺门和纵隔，总照射剂量为 46～ 62 Gy（中位数 56 Gy） ,在 5～ 7周内分 23～ 31次完成。用寿命表及 Log-rank法计算和比较两组病人的生存率与局控率。结果：两组病人的年龄、性别、病理类型等基本相同。综合组和手术组病人的 5年生存率分别为 25.5％和 23.0％（ P >0.05）。综合组病人从手术到肿瘤复发的中位时间为 21个月（ 9～ 40个月），而手术组为 12个月（ 5～ 46个月），两组比较有显著性差异（ P< 0.05）。综合组病人 1、 3、 5年局控率分别为 94.0％、 78.5％、 69.0％，明显高于手术组的 83.1％、 58.3％、 50.6％ (P< 0.05）。综合组的 5年远处转移率为 54.5％（ 30/55），手术组为 40.6％（ 26/64），两组比较无显著性差异（ P >0.05）。结论：术后放疗能提高Ⅲ a(N2)期非小细胞肺癌全切除术后病人的局控率，并延长复发出现的时间，但未能改善其生存率。
Objective: To evaluate the efficacy of radiotherapy after total resection of III a (N2) non-small cell lung cancer. Methods: From January 1989 to December 1993, 119 patients with non-small cell lung cancer who underwent radical surgery in our hospital had non-small cell lung cancer with no macroscopic and residual lens and pathological stage III a(N2). Among them, 55 patients received postoperative radiotherapy (comprehensive group) and 64 patients had no radiotherapy (operative group). Patients in the comprehensive group began to irradiate the affected hilar and mediastinum from 28 to 53 days after surgery. The total irradiation dose was 46 to 62 Gy (median 56 Gy) and was completed 23 to 31 times within 5 to 7 weeks. The survival rate and local control rate of the two groups of patients were calculated and compared using the life table and Log-rank method. Results: The two groups of patients were basically the same in age, sex, and pathological type. The 5-year survival rates of patients in the combined group and the surgical group were 25.5% and 23.0%, respectively (P > 0.05). The median time from surgery to tumor recurrence in the comprehensive group was 21 months (9 to 40 months) compared with 12 months (5 to 46 months) in the surgery group. There was a significant difference between the two groups (P<0.05). ). The control rate of patients in the comprehensive group at 1, 3, and 5 years was 94.0%, 78.5%, and 69.0%, respectively, which were significantly higher than those in the surgical group (83.1%, 58.3%, and 50.6%, respectively) (P<0.05). The 5-year distant metastasis rate in the comprehensive group was 54.5% (30/55), and 40.6% (26/64) in the surgery group. There was no significant difference between the two groups (P > 0.05). Conclusion: Postoperative radiotherapy can improve the local control rate of patients with stage IIIa (N2) non-small cell lung cancer after total resection, and prolong the time of recurrence, but failed to improve the survival rate.