早期非小细胞肺癌患者术后化疗依从性影响因素分析

Analysis of Influencing Factors of Postoperative Chemotherapy Compliance in Patients with Early Stage Non-small-cell Lung Carcinoma

目的探讨早期非小细胞肺癌患者胸腔镜肺癌根治术术后辅助化疗与常规开胸手术后辅助化疗的依从性。方法选取2001年1月至2009年12月第二军医大学长征医院胸外科收治的临床ⅠA期非小细胞肺癌患者共267例,其中,45例非小细胞肺癌患者需进行术后辅助化疗,纳入本次研究。按照患者术后化疗依从性将患者分为未化疗(14例)、部分化疗(5例)和充分化疗(26例)。比较患者术后化疗实施情况,分析术后化疗完成依从性对非小细胞肺癌患者术后长期无瘤生存率的影响。结果术后病理分期N1及以上患者45例,其中31例进行了术后辅助化疗,26例完成了4个周期。logistic回归分析显示,化疗依从性随着年龄升高而逐步降低,胸腔镜手术可提高术后辅助化疗的依从性,但并非唯一影响因素。术后辅助化疗依从性对于术后长期无瘤生存率的影响差异无统计学意义。结论对于临床ⅠA期非小细胞肺癌患者,胸腔镜肺癌根治术术后辅助化疗的依从性要好于常规开胸手术。

Objective To explore the adjuvant chemotherapy compliance between thomcotomy and videoassisted thoracoscopic surgery（VATS）in the treatment of early stage non-small-cell lung carcinoma（NSCLC）.Methods Two hundred and sixty-seven patients with early stage NSCLC who were treated in our hospital between January 2001 and December 2009 were divided into the VATS group（n=115）and the open thoracotomy group（n=152）.Analyze the factors leading to discontinue adjuvant chemotherapy in the nodal upstaging of clinical stageⅠ A NSCLC.Results Unsuspected nodal upstaging was later found in 45 patients,among them 31 received adjuvant chemotherapy and 26 completed all four cycles.Ordinal logistic regression revealed that chemotherapy compliance was significantly reduced by the patient′s age and N status.Chemotherapy compliance was increased with videoassisted thoracoscopic surgery.But it was not the only influencing factor.Conclusion The adjuvant chemotherapy compliance is superior after thoracoscopic lobectomy for early stage non-small-cell lung carcinoma（NSCLC）.