新辅助化疗对提高Ⅲ_A期非小细胞肺癌手术切除率的作用

Effect of neoadjuvant chemotherapy on surgery resection rate in patietns with stage Ⅲ_A non-small cell lung cancer

目的 探讨新辅助化疗对ⅢA 期非小细胞肺癌 (NSCLC)手术切除率的影响。方法 3 8例ⅢA 期NSCLC患者随机分为新辅助化疗组 (19例 )和单独手术组 (19例 )。新辅助化疗组患者确诊后即接受 2个周期的全身化疗 ,然后手术。单独手术组患者确诊后直接手术治疗。结果 新辅助化疗的有效率为 42 .1% ,化疗的毒副作用较轻 ,患者可以耐受。新辅助化疗组的手术切除率 94.7% ,手术完全性切除率 5 7.9% ,明显高于单独手术组患者 (P <0 .0 5 ) ,其手术切除率和完全性切除率分别为 78.9%和 3 6.8%。新辅助化疗并未增加手术并发症。结论 新辅助化疗可明显提高Ⅲ A 期NSCLC患者的手术切除率和完全性切除率。对于延长患者生存期的远期疗效尚需进一步观察。

Objective To assess the effect of neoadjuvant chemotherapy on surgical resectability in patients with stage Ⅲ A non small cell lung cancer(NSCLC).Methods 38 patients with stage Ⅲ A NSCLC were randomly and equally allocated into neoadjuvant chemotherapy group and surgery alone group.Neoadjuvant chemotherapy group received two cycle chemotherapy and then underwent surgery.Surgery alone group were treated by operation only.Results The response rate of chemotherapy was 42.1% with slight toxicities.Surgery resection rate was 94.7%,and complete resection rate was 57.9% in neoadjuvant chemotherapy group,which were much higher than those in surgery alone group(78.9% and 36.8% respectively).Complications of surgery were not increased by neoadjuvant chemotherapy.Conclusion Neoadjuvant chemotherapy can improve sugery resection rate,especially complete resection rate in patients with stage Ⅲ A NSCLC.Further studies are needed to demonstrate whether neoadjuvant chemotherapy prolongs survival time of patietns with stage Ⅲ A NSCLC.