Survival Analysis Of Radiotherapy After Radical Surgery For Stage ⅢA-N2 Non-small Cell Lung Cancer

Objective: The aim of this study was to conduct a survival analysis of whether patients with non-small cell lung cancer clinically diagnosed as stage ⅢA-N2 after radical lung cancer surgery receive modern radiotherapy techniques and to discuss risk factors that affect the prognosis of survival.Methods: The clinical data of 137 patients with pathologically confirmed stage ⅢA-N2 non-small cell lung cancer after radical lung cancer treatment admitted to our hospital between 2008 and 2019 were selected for this study.Patients were divided into two groups according to the principle of different treatment regimens: chemoradiotherapy and chemotherapy groups.Patients in the chemoradiotherapy group(n=28)received individualized three-dimensional conformal modulated intensity radiotherapy and synchronized chemotherapy alone after surgery,and patients in the chemotherapy group(n=109)received neoadjuvant chemotherapy and/or postoperative adjuvant chemotherapy.After completion of treatment,survival analysis and comparative study of general clinicopathological data of the two groups of patients were performed,and the relationship between the characteristics was compared by single and multifactor analysis with a view to exploring relevant risk factors.Results: The MST for the whole group was 43.3 months and the 1-,2-and3-year OS rates were 97.0%,78.00% and 60.00%.The MST in the chemotherapy group was 41.97 months and the 1-,2-and 3-year OS rates were97.00%,77.00% and 59.00%;the MST in the chemoradiotherapy group was69.17 months and the 1-,2-and 3-year OS rates were 96.00%,81.00% and63.00% respectively with no statistically significant difference in OS between the two groups(p=0.169).The median PFS for the whole group was 31.16 months,and the 1-,2-and 3-year PFS rates were 83.00%,64.00% and 44.00%.The median PFS in the chemotherapy group was 31.16 months,and the 1-,2-and 3-year PFS rates were 84.00% and 62.00%,and 41.00% respectively;the median PFS in the chemoradiotherapy group was 43.26 months,and the 1-,2-and 3-year PFS rates were 82.00%,70.00%,and 52.00%,with no statistically significant difference in median PFS between the two groups(p=(0.217).Risk factors for OS included preoperative chemotherapy(OR=3.855,95%CI=1.440-10.318),the metastasis and recurrence(OR=6.011,95%CI=1.113-32.457);protective factors included family history(OR=0.223,95%CI=0.052-0.47),radiotherapy(OR=0.381,95% CI=0.157-0.926).Risk factors for PFS were preoperative chemotherapy(OR=3.137,95% CI=1.063-9.258).Conclusion: Radiotherapy after radical surgery for stage ⅢA-N2 non-small cell lung cancer can effectively increase survival rate and promote prognosis,which is worthy of clinical extension and application,and can be considered for reference.