术前新辅助化疗对提高局部晚期非小细胞肺癌生存期的作用

Clinical study on improving life span of locally advanced nonsmall cell lung cancer with preoperative neoadjuvant chemotherapy

目的通过对局部晚期非小细胞肺癌(Locally advanced nonsmall cell lung cancer,LANSCLC)先行新辅助化疗,后再手术治疗,观察术前新辅助化疗对提高术后5年生存率中的作用。方法对1996年1月至2001年10月本院NSCLC203例进行前瞻性对照研究。85例行术前新辅助化疗(新辅助化疗组)2～3周期,化疗结束后3～4周手术,另118例直接手术(对照组)。结果新辅助化疗组总有效率68.24%(58/85),病期下调率35.29%(30/85);手术切除率新辅助化疗组91.25%(73/80),对照组为81.36%(96/118);两组手术并发症和手术死亡率差异无显著性(P>0.05),新辅助化疗组术后1、3、5年生存率分别为77.52%、53.85%和35.39%,对照组分别为70.88%、40.32%和24.19%,新辅助化疗组术后生存率显著高于对照组(P<0.01)。结论术前新辅助化疗安全有效,能降低NSCLC病期,提高手术切除率,改善患者术后长期生存率及生活质量。

Objective To treat locally advanced nonsmall cell lung cancer（LANSCLC） with preoperative neoadjuvant chemotherapy, the improvement on 5 years survival rate of preoperative neoadjuvant chemotherapy before surgery was evaluated . Methods 85 cases in test group had 2 - 3 cycles of preoperative neoadjuvant chemotherapy were carried out and 3 - 4 weeks after that, they underwent operation . 118 cases in control group underwent operation directly. Results The total effective rate was 68.24% （58/85） ,downstaging rate was 35.29% （30/85）in test group, the resection rate was 91. 25 % （73/80） in test group and 81.36 % （96/118 ） in control group ; there was no significant difference in operative complication and mortality between the two groups （ P 〉 0.05）, the one - years,three - year and five - year survival rate in test group were 77.52% ,53.85% and 35.39% respectively while in control group , they were 70.88% ,40.32% and 24.19% respectively ,the five - year survival rate was significantly higher in test group than in control group（P 〈 0.01）. Conclusions The preoperative neoadjuvant chemotherapy is safe and effective , which downstages NSCLC and improves the resection rate , long term survival rate and life quanlity.