Postoperative radiotherapy in resected non-small cell lung cancer: The never-ending story

Abstract

This manuscript collects in a joint and orderly manner the existing evidence at the present time about postoperative treatment with radiotherapy in non-small cell lung cancer. It also systematically reviews the current evidence, the international recommendations in the most relevant guidelines, the most controversial aspects in clinical and pathological staging, the specific technical aspects of radiotherapy treatment, and also collects all the potential risk factors that have been postulated as significant in the prognosis of these patients, evaluating the possibility of segmenting a particularly sensitive subpopulation with a high risk of relapse on which an adjuvant treatment with radiotherapy could have an impact on their clinical evolution. Finally, currently active trials that aspire to provide more evidence on this topic are reviewed.

Keywords: Non-small lung cancer; Radiotherapy; Postoperative; Lung cancer

Core Tip: The approach to the postoperative treatment of non-small cell lung cancer (NSCLC) is one of the pending subjects of the specialty of Radiation Oncology. Despite the enormous anticipation that the Lung-Art trial had produced, its results leave issues unresolved. In this article, we attempt to systematically recapitulate the currently existing evidence for the radiotherapeutic management of this pathology, in order to identify those patients who could potentially benefit more from postoperative treatment in NSCLC.