手术加化疗对Ⅰ期肺腺癌长期生存的影响

Long.term results of surgical plus chemotherapy for stage Ⅰ lung adenocarcinorma

目的研究术后化疗对Ⅰ期肺腺癌长期生存的影响。方法收集1995年1月-2005年1月手术切除Ⅰ期（Ⅰa＋Ⅰb）肺腺癌427例，比较术后化疗组与单纯手术组的治疗效果。结果Ⅰa期1、3、5、10年生存率，术后化疗组为100．00％、92．34％、86．17％、74．82％。单纯手术组为96．63％、88．11％、79．52％、65．85％。Ⅰb期1、3、5、10年生存率，术后化疗组为96．84％、77．99％、69。56％、64．36％。单纯手术组为85．65％、67．11％、59．56％、53．06％。Ⅰa、Ⅰb期术后化疗组与单纯手术组1年生存率比较差异均有统计学意义（P〈0．05，P〈0．01）。结论Ⅰa和Ⅰb术后化疗均比单纯手术预后好；Ⅰ期肺腺癌要取得较好的治疗效果，手术加术后化疗模式不可缺少。

Objective Observe the effect of operation plus post-operative chemotherapy for long- term results of stage Ⅰ lung adenocarcinorma. Methods From January 1994 to January 2005, 427 patients with stage I lung adenocarcinorma underwent surgical resection therapy. The comparison of long-term survival rates was made between post-chemotherapy and surgical resection alone. Results The analyses disclosed that the stage Ⅰ a 1, 3, 5 and 10-year survival rate of post-chemotherapy was 100. 00%, 92. 34%, 86. 17% and 74. 82%, respectively, while in surgical resection alone was 96.63%, 88. 11%, 79.52% and 65.85%, respectively. The stage Ⅰ b 1, 3, 5 and 10-year survival rate of post-chemotherapy was 96. 84%, 77. 99%, 69. 56% and 64. 36%, respectively, while in surgical resection alone was 85. 65% ,67. 11%, 59. 56% and 53.06%, respectively. There was statistically significant difference between 1 year survival rate of stage Ⅰ a patients with post-chemotherapy and those with surgical resection alone （P 〈 0. 05 ） ; 1 year survival rate of stage Ⅰ b patients with post-chemotherapy and those with surgical resection alone （ P 〈 0. 01 ）. Conclusion The operation plus post-operative chemotherapy is better than surgical resection alone in stage Ⅰ a and Ⅰ b. Surgical plus post-operative chemotherapy mode is indispensable for better prognosis of stage Ⅰ a and Ⅰ b lung adenocarcinorma.