术前化疗对小细胞肺癌远期生存的影响

Preoperative Chemotherapy for Long-term Results of Small Cell Lung Cancer

目的观察术前化疗联合外科手术治疗对小细胞肺癌（SCLC）长期生存的影响。方法总结北京市结核病胸部肿瘤研究所1994年1月至2005年1月手术切除的263例SCLC的综合治疗效果。比较术前化疗组（A组，n=111例）和术后化疗组（B组，n=96例）的治疗效果。结果全组5年生存率42．16％。A组5年生存率38．25％，B组5年生存4657％。A组5年生存率I期60．15％、Ⅱ期35．70％、Ⅲ。期40．16％、Ⅲb期14．29％、Ⅳ期0，A组5年生存率NO-1和N2为4012％和39．22％。B组5年生存率Ⅰ期61．10％、Ⅱ期50．23％、Ⅲa期42．32％、Ⅲb期2647％、Ⅳ期0，B组5年生存率NO-1和N2组为51．91％和42．69％。结论术前化疗病例比术后化疗病例有预后变差倾向；SCLC要取得较好的治疗效果，手术＋术后化疗模式不可缺少。

Objective To reveal the pre-operative chemotherapy for long-term of small cell lung cancer. Methods From January 1994 to January 2005, 263 patients with small cell lung cancer underwent combined therapy. The comparison of long-term survival rates was made between pre-operative chemotherapy group （n =111） （ group A） and post-operative 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%. 5-year survival rate of group A for NO-1 and N2 was 40.12% and 39.22%, that for stage Ⅰ, Ⅱ, Ⅲa, Ⅲb, Ⅳwas 60.15%, 35.70%, 40.16%, 14.29% and 0 respectively. 5-year survival rate of group B for N0-1 and N2 was 51.91% and 42.69%, that for stage Ⅰ, Ⅱ, Ⅲa, Ⅲb,Ⅳwas 61.1%, 50.23%, 42.32%, 26.47% and 0 respectively. Conclusion The comparison of the survival rate between patients with the preoperative chemotherapy and those with chemotherapy post-operatively revealed trend of variation. Operation plus post-operative chemotherapy mode is indispensable for better prognosis of small cell lung cancer. Key words Lung neoplasms Drug therapy, combination Premedication