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Background  To establish a prediction model in selecting fit patients with resected p IIIA‐N2  non‐small cell lung cancer ( NSCLC)  for postoperative radiotherapy ( PORT ), and evaluate the model in clinical practice.    Methods  Between  J anuary 2003 and  D ecember 2005, 221 patients with resected p IIIA‐N2 NSCLC  were retrospectively analyzed. The effect of  PORT  on overall survival ( OS ) of patients with different clinicopathological factors was evaluated and the results were used to establish a prediction model to select patients fit for  PORT .    Results  Compared with the control,  PORT  significantly improved the  OS  of patients with a smoking index ≤400 ( P  = 0.033),  cN2  ( P  = 0.003),  pT3  ( P  = 0.014), squamous cell carcinoma ( SCC)  ( P  = 0.013), or ≥4 positive nodes ( P  = 0.025). Patients were divided from zero to all five factors into low, middle, and high  PORT  index ( PORT ‐ I ) groups (scored 0–1, 2, and 3–5, respectively).  PORT  did not improve  OS  (3‐year,  P  = 0.531), disease free survival ( DFS ) ( P  = 0.358), or loco‐regional recurrence free survival ( LRFS ) ( P  = 0.412) in the low  PORT ‐ I  group.  PORT  significantly improved  OS  ( P  = 0.033), and tended to improve  DFS  ( P  = 0.064), but not  LRFS  ( P  = 0.287) in the middle  PORT ‐ I  group.  PORT  could significantly improve  OS  ( P  = 0.000),  DFS  ( P  = 0.000), and  LRFS  ( P  = 0.006) in the high  PORT ‐ I  group.    Conclusion  The prediction model is valuable in selecting patients with resected p IIIA‐N2 NSCLC  fit for  PORT .  PORT  is strongly recommended for patients with three or more of the five factors of smoking index ≤400,  cN2 ,  pT3 ,  SCC , and ≥4 positive nodes.

Selection of proper candidates with resected pathological stage IIIA‐N2 non‐small cell lung cancer for postoperative radiotherapy