新辅助化疗对ⅢA-N_2期NSCLC疗效的临床分析

Clinical Analysis of the Efficacy of Neoadjuvant Chemotherapy for Stage ⅢA-N_2 NSCLC Patients

目的:探讨新辅助化疗对于ⅢA-N_2期NSCLC的降期作用及疗效。方法:回顾性分析2004年1月至2008年12月期间26例接受新辅助和44例术后辅助化疗的ⅢA-N_2期NSCLC患者的临床资料。结果:新辅助化疗组R_0切除22例,10例降期至_N1,6例降期至N0,R_0切除率为84.6%;辅助化疗组R_0切除率为54.55%,两组差异有统计学意义。3年生存率新辅助化疗组为73%,辅助化疗组为49%,两组差异有统计学意义(P<0.05)。结论:新辅助化疗可明显改善ⅢA-N_2期患者手术效果,降低N分期,提高患者生存,同时并未增加手术并发症和患者死亡。

Objective： To investigate the clinical efficacy and adverse events of neoadjuvant chemotherapy for stage IIIA-N2 NSCLC patients. Methods： The clinical data of 26 stage IIIA-N2 NSCLC patients who had been treated with neoadjuvant and 44 cases of stage IIIA-N2 NSCLC who accepted post-operative adjuvant chemotherapy from Jan. 2004 to Dec. 2008 were analyzed retrospectively. Results： Twenty-two cases got R0 resection, ten cases were lowered to N1 stage, 6 cases were lowered to NO stage. The R0 resection rate was 84. 62% and 54. 55% in neoadjuvant and adjuvant group, respectively. The difference was significant. The 3 year survival rate was 73% and 49% in neoadjuvant and adjuvant group respectively with significant difference（ P 〈 0. 05 ）. Conclusion： Neoadjuvant chemotherapy could significantly increase the therapeutic effect of surgery for stage IIIA-N2 NSCLC patients as well as lower the N staging and improve the survival rate without increasing the complications of surgery and mortality of patients.