The study comprised 702 patients radically operated on for non-small cell cancer of the lung: surgery alone--351; radiation + surgery --110; (Eighty-seven patients of the latter group received an intensive course of radiation with a total target dose (TTD) of 20 Gy); surgery + fractionated radiation with TTD 50-55 Gy--195; radiation + surgery + radiation--46. No significant increase in overall or stage-related survival was registered for application of either modality as compared with controls. To establish indications for adjuvant radiotherapy, a prognostic factor study was undertaken using the regression model of Cox. The presence of metastasis in mediastinal nodes (N2) is considered the main indication for combined treatment. In the absence of metastasis in the regional nodes (N0) or in case of metastatic involvement of the nodes of the radix pulmonis (N1), adjuvant radiotherapy was not followed by a significant increase in survival rates even in cases of extensive local primary tumor (T3) and other unfavorable factors. Surgery + radiation or radiation + surgery + radiation for extensive non-small cell disease (T1-3N2M0) led to a significant (p < 0.05) rise in overall and recurrence-free survival rates and reduced the risk of local recurrences as compared with surgery alone.
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