术前长春瑞滨和顺铂化疗在Ⅲ期非小细胞肺癌治疗中的应用

Application of combined chemotherapy with vinorelbine and cisplatin in treatment of stageⅢ non-small cell lung cancer before operation

目的:探讨长春瑞滨和顺铂(NP方案)术前新辅助化疗在Ⅲ期非小细胞肺癌治疗中的疗效。方法:采用本院2006年3月-2007年12月57例Ⅲ期非小细胞肺癌患者进行回顾性研究,试验组21例,同期对照组36例。试验组患者在术前经细胞学或病理确诊为NSCLC,术前确定肺癌局限于一侧胸腔,无对侧纵隔淋巴结转移,属ⅢA、ⅢB期肺癌,未接受过化、放疗,且经全面检查评价能耐受外科手术者。以同期未行新辅助化疗的III期NSCLC患者作为对照,试验组给予术前NVB+DDP化疗两周期,对照组则直接行手术治疗。结果:新辅助化疗组有效率为76.19%(16/21),毒副反应主要为消化道和血液系统,静脉炎发生率为14.29%(3/21),临床分期下降率为52.38%(11/21),手术切除率为95.24%(20/21),对照组切除率为86.11%(31/36)。结论:长春瑞滨和顺铂(NP方案)术前新辅助化疗总有效率较高,毒副反应小,疗效满意,新辅助化疗用于治疗Ⅲ期NSCLC能明显提高肺癌的治愈率,改善远期生活质量。

Objective： To explore the application of combined chemotherapy with vinorelbine and cisplatin in treatment of stage Ⅲ non-small cell lung cancer （ NSCLC ） before operation. Methods： A retrospective study was made in 57 patients with stage Ⅲ non-small cell lung cancer admitted to our hospital from March 2006 to December 2007. The patients were divided into experimental group （ n=21 ） and control group （ n=36 ）. Patients in experimental group were diagnosed as NSCLC by pathology. After a systematical examination, they were diagnosed as Ⅲ A and Ⅲ B lung cancer. Patients in experimental group received two cycles of NVB＋DDP chemotherapy before operation, while patients in control group underwent operation. Results： The patients in experimental group responded to chemotherapy. The negative effect was observed mainly in digestive and blood systems. The effective rate was 52.38% （ 11/21 ）. The resection rate was 95.24% （ 20/21 ） in experimental group and 86.11% （ 31/36 ） in control group. Conclusion： Combined chemotherapy with vinorelbine and cisplatin has a high total effective rate for stage Ⅲ non-small cell lung cancer with few adverse effects, and can improve the quality of patient life.