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 Adenocarcinoma

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9663％、88．11％、79．52％、65．85％。Ⅰb期1、3、5、10年生存率，术后化疗组为96馏4％、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 adenocarcinoma. Methods From January 1994 to January 2005, 427 patients with stage I lung adenocarcinoma 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 la 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 1 a and I b.Surgical plus post-operative chemotherapy mode is indispensable for better prognosis of stage Ia and lb lung adenocarcinoma.