外科手术切除是早期非小细胞肺癌的标准治疗方式，文献报道外科可以提供给早期肺癌病人最佳的治愈率。然而，标准的肺叶切除或全肺切除及纵隔淋巴结清扫后IA病人的5年生存率为68.5%，IB为66.6%，许多病人死于癌转移［1］。而肺段切除则较多发生局部复发［2］。传统上，为了改善肺癌病人的术后生存率，减少局部复发，术后一般加用化疗或放疗或放化疗联合应用，或一些生物、分子治疗。那么这种术后的辅助治疗能多大程度的提高肺癌病人的生存率，特别是对于完全切除后的早期非小细胞肺癌病人，到目前为止，仍然没有明确的定论，是个值得研究的问题。
⒈ 辅助放射治疗
小结：①没有证据表明早期肺癌（I-II期）术后辅助放疗能改善病人的生存率，且放疗的副作用会增加病人的生存危险。只有很少的证据表明肺癌术后辅助放疗会减少肿瘤的局部复发，并可能改善IIIA病人的生存率。②肿瘤局部切除手术后手术切缘的外部照射可能减少局部复发。③肺癌肺段或局部肿瘤切除术中进行近距离照射（125I离子植入）可减少肿瘤的局部复发，但能否改善病人的5年生存率需进一步临床试验。
⒉ 辅助化疗
小结：①IA期NSCLC完全切除术后不主张辅助化疗。②IB期病人术后辅以铂类为基础的化疗可能有临床上的生存改善，但仍然没有定论。③II，III期NSCLC完全的肺叶切除或全肺切除术后主张辅助化疗。④术后口服UFT辅助化疗可能对完全切除的IA或IB NSCLC有一定的临床意义。
⒊关于肺癌的分子靶向治疗
完全切除的I期非小细胞肺癌超过三分之一的病例与5年内发生远处转移并最终死于肿瘤的复发或转移。辅助化疗可能改善4-15%的病人生存率［25］，但大部分病人却忍受效果不佳的化疗所带来的毒性反应。
近年来，随着分子生物学技术的提高和在细胞受体及增值调控的分子水平对肿瘤发病机制的进一步认识，人们开始了针对细胞受体、关键基因和调控分子为靶点的治疗，并称之为“分子靶向治疗”。分子靶向药物是将肿瘤细胞膜上或细胞内特异性表达或高表达的分子作为靶点，这不仅能更加特异地作用于肿瘤细胞，阻断其生长、转移或诱导其凋亡，同时降低了对正常细胞的杀伤作用，毒副作用较小。目前有以表皮生长因子EGFR/HER-1为靶点的药物吉非替尼（易瑞沙，gefitinib）和厄洛替尼（特罗凯，erlotinib），有以血管生成因子VEGF为靶点的药物贝伐单抗 (Avastin, bevacizumab)和血管内皮抑素（恩度，endostatin）等。
目前肺癌的分子靶向治疗普遍用于晚期非小细胞肺癌的研究，且由于研究历史较短，还存在诸如如何准确发现最可能获益的“靶向治疗”患者？如何提高靶向治疗与手术、放疗、化疗联合使用的疗效？“靶向药物”的最佳药用量等等。国际上还没有早期非小细胞肺癌术后“靶向治疗”的研究，有待于进一步的基础和临床实验。
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