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目的 探讨Ⅲａ 期非小细胞肺癌术后放疗和化疗的增益程度及其失败原因。方法 采用单因素和多因素Ｃｏｘ 回归模型，对１０７ 例Ⅲａ 期非小细胞肺癌根治术后放疗和／ 或化疗的疗效增益特点及失败原因分析。结果 其单纯手术（Ｓ） 、手术＋ 化疗（Ｓ＋ Ｃ） 、手术＋ 放疗（Ｓ＋ Ｒ） 、手术＋ 放疗＋ 化疗（Ｓ＋ Ｒ＋ Ｃ）５ 年生存率分别为２０ ．８ ％ 、２４ ．３ ％ 、２５ ．０ ％ 、３４ ．６ ％ 。但接受放疗者５ 年无复发生存率为８８ ．５ ％ ，明显高于未放疗者的６９ ．２ ％ （ Ｐ ＜ ０ ．０５） 。术后化疗者的远处转移时间为２１ ．８ 个月，明显高于未化疗的１４ ．８ 个月，但４ 组的５ 年无转移生存率无明显差异。Ｎ 分期是生存率的独立预后因子（ Ｐ＝ ０ ．０１３） ，并且是远处转移的高危因素（ Ｐ＝ ０ ．０５８６） 。结论 对Ｎ２ 分期亚组患者应采用术后放疗联合化疗。
Objective To investigate the degree of postoperative radiotherapy and chemotherapy for stage IIIa non-small cell lung cancer and the reasons for its failure. Methods The univariate and multivariate Cox regression models were used to analyze the efficacy and failure of radiotherapy and/or chemotherapy after radical resection of 107 cases of stage IIIa non-small cell lung cancer. Results The 5-year survival rates of surgery (S), surgery + chemotherapy (S + C), surgery + radiation (S + R), surgery + radiation + chemotherapy (S + R + C) were 20. 8 %, 24 . 3%, 25. 0 %, 34. 6 %. However, the 5-year recurrence-free survival rate was 88. 5% was significantly higher than that of non-radiotherapy 69. 2% (P < 0 .05). The distant metastasis time of postoperative chemotherapy was 21. At 8 months, it was significantly higher than that without chemotherapy. At 8 months, there was no significant difference in the 5-year non-metastatic survival rate in the 4 groups. N staging was an independent prognostic factor for survival (P = .013) and was a risk factor for distant metastasis (P = .0586). Conclusion Postoperative radiotherapy combined with chemotherapy should be used in N2 subgroup patients.