介入性新辅助化疗治疗Ⅲ期非小细胞肺癌的临床病理学疗效观察

Clinicopathological observation of interventional neoadjuvant chemotherapy in patients with stage Ⅲ non-small cell lung cancer

目的 评价介入性 (支气管动脉灌注 ,BAI)新辅助化疗治疗Ⅲ期非小细胞肺癌 (NSCLC)的临床及病理组织学疗效。方法 36例Ⅲ期NSCLC患者在接受 1～ 3个疗程的BAI化疗后手术 ,观察BAI化疗的临床疗效和病理组织学反应。结果 36例患者BAI化疗后总有效率 (RR) 5 5 .6 %。给予 2～ 3个疗程BAI化疗的RR为 76 .2 % (16 /2 2 ) ,明显高于给予 1个疗程化疗的 2 8.6 % (4/14 ) (P <0 .0 5 )。术后病理学观察显示 ,接受 2～ 3个疗程BAI化疗的总的组织学有效率 (HRR)为 6 1.9% (13/2 1) ,明显高于接受1个疗程BAI化疗的HRR 2 3.1% (3/13) (P <0 .0 5 )。临床疗效与病理组织学疗效并不完全一致。结论介入性 (BAI)新辅助化疗治疗Ⅲ期NSCLC以 2～ 3个疗程的疗效为优。化疗效果应结合临床和病理组织学疗效共同评价。

Objective To evaluate the clinical and pathohistological response of the interventional (bronchial artery infusion, BAI) neoadjuvant chemotherapy for the patients with stage Ⅲ non-small cell lung cancer (NSCLC). Methods 36 patients with stage Ⅲ NSCLC were treated by BAI chemotherapy for 1～3 courses, and then underwent surgery. Clinical and pathohistological response were analyzed. Results The clinical response rate (RR) was 55.6% . Clinical RR was higher significantly in patients who had received 2 and 3 courses than those received 1 course of BAI chemotherapy ( 76.2% vs 28.6% , P < 0.05 ). The pathological examination shown that the histological response rate (HRR) was 61.9% (13/21) in the patients treated with BAI chemotherapy for 2 and 3 courses, as compared with 23.1% (3/13) in the patients treated with BAI chemotherapy for 1 course ( P < 0.05 ). Clinical response was not fully consistent with histological response. Conclusion Interventional (BAI) neoadjuvant chemotherapy has a good clinical and histological response against tumor of stage Ⅲ NSCLC. Effect of 2 and 3 courses is better than that of 1 course of BAI chemotherapy.