Do you ever recommend PORT or chemoRT rather than chemotherapy alone for NSCLC with adverse features other than positive margins or N2 disease?

Despite the numerous limitations of the PORT meta-analysis, and subsequent non-randomized studies of postoperative RT in NSCLC, one message seems clear (at least to me)- radiation therapy can cause harm. In patients with resected lung cancer (who often have many co-morbidities), prudence seems a wise course.

While I personally believe that radiation therapy is appropriate in certain subsets of resected NSCLC, there is limited level 1 evidence to support it. Based on clinicaltrials.gov, the random...

I agree completely with @Dr. First Last. The only other group that could be considered for PORT is the rare patient that had involved hilar nodes and inadequate surgery in the mediastinum. I’ve seen cases where the procedure needed to be halted for medical reasons before the mediastinum was dissected. I’ve also even a few cases done by cardiothoracic surgeons (rather than thoracic surgeons that see lung cancer every day) where mediastinal dissection was either not done or inadequate. In these ch...