NSCLC术前化疗后“T”降期的临床评价

Evaluate T (tumor) Downstaging after Preoperative Chemotherapy in Non-small-cell Lung Cancer

目的 :研究NSCLC术前化疗后临床、组织学缓解率和化疗前后“T”分期变化及中数生存期的关系。方法 :自 1995年 2月～ 1997年 2月 ,5 6例经诱导化疗后手术的非小细胞肺癌 ,以铂类为基础的联合化疗 1～ 2个疗程 ,按TNM分期系统评价期别、“T”降期。结果 :期别降期发生率为 2 1.4% ,“T”降期发生率 2 3.2 %。化疗 2个周期的“T”降期比例明显高于 1个周期 (P<0 .0 5 ) ,“T”降期与化疗临床缓解率和组织学缓解率相关 (P <0 .0 5 ) ;“T”降期组的中数生存期高于“T”无变化和“T”升期组 ,分别为 45 .2 8个月、33.30个月和 2 4.0 3个月 ,但差异无统计学意义 ,P =0 .142 3。进一步分析 ,在N2中“T”降期组MST较长 ,但P =0 .0 6 86。同样在腺癌中 ,“T”降期组MST较“T”无变化和升期组延长。P =0 .0 5 94。结论 :化疗后降期和“T”降期分别是反映化疗疗效因素之一 ;可延长生存期。

Objective: The tumor and histological response rate and T (tumor) downstaging were analysis of preoperative cisplatin-based chemotherapy in non-small-cell lung cancer. Methods: From 1995.2 to 1997.2, 56 patients with NSCLC underwent adjuvant chemotherapy sequent surgery. The cisplatin-based chemotherapy was given to patients preoperatively with 1-2 courses. The postoperative downstaging and T downstaging were assessed according to TNM standard. Results: Downstaging rate was 21.4%. T downstaging rate was 23.2%. T downstaging was more numerous in 2 courses patient than in 1 course patients ( P <0.05). T downstaging was related with clinical response rate and histological response rate ( P <0.05). T downstaging affected the median survival time, but P =0.0686. MST of T downstaging was longer than other group in N2, P =0.0686, the same in adnocarcinoma, P =0.0594. Conclusion: It was one of factors to reflect the response of chemotherapy that downstaging and 'T' downstaging after chemotherapy.