Ⅲ期非小细胞肺癌术后辅助化疗临床观察

Clinical Observation of Adjuvant Chemotherapy after Radical Surgery for Stage Ⅲ Non - Small Cell Lung Cancer

〔目的〕评价Ⅲ期非小细胞肺癌（NSCLC）根治术后辅助化疗疗效及其TNM分期与预后的关系。［方法］回顾性总结68例根治术后的Ⅲ期NSCIL，其中42例于术后3～4周开始接受化疗（辅助化疗组），予以MVP或CAP方案，每4～6周重复，第一年完成4～6个疗程，第2年完成2个疗程，共6～8个疗程。另26例患者术后来行化疗（单纯手术组）。［结果］辅助化疗组和单纯手术组的5年生存率分别为42.9%和19.2%（P＜0.05），中位生存期分别为36.5个月和13.4个月。［结论］辅助化疗组疗效明显优于单纯手术组。TNM分期状况与预后密切相关，T3N0M0疗效好，胸内淋巴结受累特别是N2为Ⅲ期肺癌疗效差的主要原因。

[Purpose]To evaluate the effect of adjuvant chemotherapy after radical surgery for stage m non - small cell lung cancer(NSCLC)and the relationship between TNM Stag and prognosis. [Methods] We analysed clinical data in 68 cases of stage Ⅲ NSCLC undergone radicalsurgery. Forty-two patients received adjuvant chemotherapy with regimen of MVP(MMC + VCR + PDD) or CAP(Cry + ADM + PDD) for 6 or 8cycles in two years(adjuvant chemotherapy gruop). Twenty - six patients received surgery alone (surgery group). [Results]The 5 - year survival ratewas 42 .9% in the adjuvant chemotherapy group and 19. 2% in the surgery gruop. Their median survival times we 36. 5 months and 13. 4 monthsrespectively. The difference between the two groups was statistically significance (P < 0.05 ). [Conclusion] The effect of adjuvant chemotherapygroup is significantly superior to that of surgery group. It is demonstrated that TNM stage is close related to prognosis in stage Ⅲ NSCLC. Theprognosis of T3N0M0 is much better than that of T3N2M0. Thoracic lymph node metastasis is associated with poor prognosis.