术前诱导化疗治疗20例巨大恶性胸腺肿瘤的临床观察

The Reduction Chemotherapy to the Gigantic Thymic Malignant Tumor before Surgical Treatment

目的:探讨术前化疗在巨大恶性胸腺肿瘤治疗效果中的作用。方法:采用前瞻性和回顾相结合,对比分析40例巨大恶性胸腺肿瘤化疗组与对照组的手术情况和疗效。结果:化疗组较对照组手术切除率提高,术中出血量减少,上腔静脉综合征消失,围手术期死亡减少,并有显著性差异;1、3、5年生存率化疗组较对照组明显提高。结论:凡术前估计手术不能彻底切除肿瘤者均应给予术前诱导化疗,包括1)临床有上腔静脉阻塞综合征表现者;2)胸部CT示肿瘤巨大,占据整个前纵隔间隙,血管界面消失;3)肿瘤向双侧肺门生长,术前估计手术可能创伤隔神经者;4)有胸腔积液者。

Objiective: Analysis the value of the chemotherapy before operation to the gigantic thymic maliglnt tumor. Methods: to compare the results of operation between chemotherapy and no chemotherapy group with retrospectively and prospectively Results: the group of reduction chemotherapy has a high rate of resection, low volume of bleeding, the disappear of the obstructive syndrome of superior vena cava, low mortality after operation. the high level of the survival rates for 1/3 5 years of reduction chemotherapy group compared with that of no reduction chemotherapy. Conclusions: we should give a reduction chemotherapy if we can't performed a radical resection estimate with CT and clinic syndrome such as the obstructive syndrome of superior vena cava. that is included: 1. the obstructive syndrome of superior cavity vein. that is included. 2 CT scan: gigantic tumor located in all the period of anterior mediastinal, the disappear of the surface of the huge blood vessel. 3 the growth of tumor towards double pleural, the phrenic nerve will be injured probably. 4 company with thoraxfluid.