Radiaton plus Surgery for Advanced Lung Cancer

**Lung Cancer Surgery plus Radiation**
For non-small cell carcinoma of the lung, surgery is the treatment of choice (if the cancer is resectable or the patient can tolerate surgery. If surgery cannot be performed than radiation plus chemotherapy is used, go here). For some cancers that are locally advanced (growing into the chest wall) the patient may benefit from radiation prior to surgery (see section on preOp and NCCN on preOp.) If surgery is performed successfully, some patients may still benefit from postoperative radiation, particular if the surgical margins are involved or there has been spread to the lymph nodes (see section on PostOp radiation for early cases and for more advanced cases.)

	specific topics understanding stage III lung cancer mediastinal lymph nodes definition of node stations lymph node pathways in the lung survival with stage III lung cancer routine postoperative radiation radiation prior to surgery (preoperative) chemo or radiation before surgery (induction) understanding neoadjuvant chemotherapy see the NCCN Guidelines indications radiation/surgery: PostOp T1/T2, PostOp for T3, PreOp for N2, XRT alone for IIIB. or PreOp for T4 (Pancoast)

Overall Survival among Patients with Stage II or IIIa Non-Small-Cell Lung Cancer, According to Whether They Received Postoperative Radiotherapy Alone or Radiotherapy and Chemotherapy

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Keller N Engl J Med 2000;343:1217-22.

Phase II Trial of Postoperative Adjuvant Paclitaxel/Carboplatin and Thoracic Radiotherapy in Resected Stage II and IIIA Non–Small-Cell Lung Cancer: Promising Long-Term Results of the Radiation Therapy Oncology Group—RTOG 9705

Journal of Clinical Oncology, Vol 23, No 15 (May 20), 2005: pp. 3480-3487