Radiation therapy is not recommended after surgery for cut margin negative, stage N0-1 non-small cell lung cancer

  At the 56th Annual American Society for Radiation Oncology (ASTRO) meeting in September 2014, recommendations were issued for early-stage non-small cell lung cancer (NSCLC): Radiation therapy is not recommended for patients with cut-off-negative, N0-1 stage non-small cell lung cancer (NSCLC) after surgical treatment.  Management of patients with early-stage non-small cell lung cancer after surgery includes observation, chemotherapy, and radiotherapy. Two meta-analyses examined the effect of postoperative radiotherapy in patients with lymph node negative or stage N1 (lymph node metastasis limited to the ipsilateral hilum) early-stage NSCLC and concluded that radiotherapy compared with observation was not beneficial for disease-free survival or overall survival, except for increased side effects. However, postoperative radiotherapy in patients with positive cut margins would help improve local control.