With the development of modern radiotherapy technology, the significance of postoperative radiotherapy in treating resectable stage Ⅲ A-N 2 non-small cell lung cancer has been emphasized. At present, the value of postoperative radiotherapy has been controversial due to the lack of large-size prospective randomized controlled studies. A large number of retrospective studies have confirmed that the efficacy of postoperative radiotherapy is significantly correlated with different clinicopathological characteristics. In this article, the influencing factors of the efficacy of postoperative radiotherapy were analyzed, and the subgroup of patients receiving clinical benefits was discussed, aiming to achieve precise postoperative radiotherapy.

Background and objective hTere is no high-level evidence for the time of whole brain radiotherapy (WBRT) for patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) and brain metastases. hTe aim of this study is to assess the appropriate timing of WBRT for patients withEGFR-mutated NSCLC and brain metastases (BM).Methods hTere were 78 patients diagnosed withEGFR-mutated NSCLC and BM in Beijing Chest Hospital between August 2009 and May 2015. 48 untreated patients who received both WBRT and EGFR-tyrosine kinase inhibitors (TKIs) therapy. Prognostic factors of intracranial progression-free survival (PFS) and overall survival (OS) were identiifed byCox proportional hazards modeling.Results Intracranial objective response rate was 81.3% and disease control rate was 93.8%. Median intracranial PFS was 10 months. Median OS was 18 months. Multivariate analysis of intracranial PFS revealed that Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1 (HR=30.436, 95%CI: 4.721-196.211, P<0.001) and early WBRT (HR=3.663, 95%CI: 1.657-8.098,P=0.001) had a better intracranial PFS. Multivariate analysis of OS revealed that PS 0-1 (HR=57.607, 95%CI: 6.135-540.953,P<0.001), early WBRT (HR=2.757, 95%CI: 1.140-6.669,P=0.024), and stereotactic radiosurgery (HR=5.964, 95%CI: 1.895-18.767,P=0.002) were independent prognostic factors of OS.Conclusion Early WBRT combined with EGFR-TKIs can improve outcomes of patients withEGFR-mutated NSCLC and BM, but it needs to be conifrmed by large-sample-size and multicenter prospective clinical trials.