术中置药并术后胸腔灌注治疗Ⅲa期非小细胞肺癌的疗效观察

Efficacy of set medicine during the operation and thoracic infusion after surgery in treatment of Ⅲ a non-small cell lung cancer

目的 探讨Ⅲa期非小细胞肺癌的有效治疗方法.方法 将53例Ⅲa期非小细胞肺癌患者分为观察组(26例)和对照组(27例).观察组术中用吡柔比星(THP)10 mg、环磷酰胺(CTX)200 mg、卡铂(CBP)50 mg置入清扫淋巴结处,以及术后行胸腔灌注吡柔比星50 mg、环磷酰胺600 mg、卡铂水针300 mg、α-干扰素500万U.两组均于手术后第3周采用紫杉醇(PTX)+THP+CBP/顺铂(DDP)或吉西他滨(GEM)+CBP/DDP及PTX+奥沙利铂(L-OHP)或异长春花碱(NVB)+L-OHP等多种方案交替静脉联合化疗,4周为一疗程,共4-6个疗程.随访3年进行疗效比较.结果 观察组1、2、3年生存率分别为88.4%、76.9%和46.1%,对照组依次为77.8%、44.4%和33.3%.结论 Ⅲa期非小细胞肺癌手术并术中置药术后胸腔灌注,辅以早期联合静脉化疗,可提高患者生活质量及生存率.

Objective To investigate an effective approach for stage Ⅲ a non- small cell lung cancer. Methods The stage Ⅲ a non-small cell lung cancer were divided into observation group (26 cases) and control group(27 cases). The observation were set THP 10 mg, CTX 200 mg, CBP 50 mg on lymph during the operation and were given THP 50 mg, CTX 600 mg, CBP 300 mg, IFN-α thoracic infusion chemotherapy after surgery. All of two groups(53 cases)received alternate intravenous chemotherapy of PTX + THP + CBP/DDP or GEM + CBP/DDP or PTX + L-OHP or NVB + L-OHP regimens in 3weeks after surgery and repeat every 4 weeks. The patients had 4 to 6 therapeutic course. The follow-up survery was compared after the treatment between the two groups. Results 1,2,3 years survival rates were 88.4% ,76. 9% and 46.1% in the observation group as compared with 77.8% ,44.4% and 25.9% in the control grouup respectively. Conclusions Operation set chemicals in surgery and given thoracic infusion chemotherapy after surgery and combined chemotherapy is an effective way for treatment of stage Ⅲ a non -small cell lung cancer. It can improve the life quality and survival rates of the patients.