术前新辅助化疗对小细胞肺癌远期生存的影响

Long-Term Results of Preoperative Neoadjuvant Chemotherapy for Small Cell Lung Cancer

目的揭示术前新辅助化疗对小细胞肺癌（SCLC）长期生存的影响对外科临床十分重要。方法总结1994年1月。2005年1月手术切除263例SCLC的综合治疗效果。分析比较术前新辅助化疗组（A组，n=111例）和术后化疗组（B组，n=96例）的治疗效果。结果A组5年生存率38．25％，B组5年生存46．57％。A组5年生存率Ⅰ期60．15％、Ⅱ期35．70％、Ⅲa期40．16％、Ⅲb期14．29％、Ⅳ期0，5年生存率N0-1和N2组为40，12％和39．22％。B组5年生存率Ⅰ期61．10％、Ⅱ期50．23％、Ⅲa期42．32％、Ⅲb期26．47％、1V期0，5年生存率N0-1和N2组为51．91％和42．69％。结论新辅助化疗病例与术后化疗病例相比预后差：SCLC要取得较好的治疗效果，术后化疗模式不可缺少。

Objective To investigate the influence of preoperative neoadjuvant chemotherapy on long-term results of small cell lung cancer. Methods We retrospectively analyzed 263 patients with small cell lung cancer undergone combined modality therapy from January 1994 to January 2005. The long-term survival rate was compared between preoperative neoadjuvant chemotherapy group （n=111） （group A） and postoperative chemotherapy （n=96） （group B）. Results The analyses disclosed that the overall 5- year survival rate was 42.16%. The 5-year survival rate of group A was 38.25% while in group B it was 46.57%. The 5-year survival rate of group A for No-1 was 40.12% and Nz 39.22%, and that of stage Ⅰ , Ⅱ, Ⅲa, Ⅲb, Ⅳ was 60.15%, 35.70%, 40.16%, 14.29% and 0 respectively. The 5-year survival rate of group B for N0-1 was 51.91% and N2 42.69%, and that of stage Ⅰ , Ⅱ, Ⅲa, Ⅲb, IV was 61.1%, 50.23%, 42.32%, 26.47% and 0 respectively. Conclusion The prognosis of patients with the preoperative neoadjuvant chemotherapy is inferior to that of postoperative chemotherapy. Postoperative chemotherapy mode is indispensable to better prognosis of small cell lung cancer.