新辅助化疗在ⅢA期非小细胞肺癌术前应用临床分析

The application of preoperative neoadjuvant chemotherapy in patients with stageⅢA non-small cell lung cancer

目的 研究探讨ⅢA期非小细胞肺癌(NSCLC)患者采用术前新辅助化疗的近-中期临床疗效.方法 2008年3月至2015年10月,观察组共计92例ⅢA期NSCLC患者,均接受2周期的术前新辅助化疗并于化疗结束后3～4周行常规肺癌根治手术;同期65例未行术前化疗而直接手术的ⅢA期NSCLC患者作为对照.对两组患者住院期间临床资料及术后随访资料进行回顾性分析.结果 观察组术前新辅助化疗有效率为73.9％,所有患者均经胸腔镜或常规开胸完成肺癌根治术,无手术死亡,术后病理均符合NSCLC;两组患者的手术时间和术中出血量差异无统计学意义(P>0.05),观察组手术切除率高于对照组(P=0.048);术后随访3年内无失访,观察组2年、3年生存率略高于对照组.结论 对NSCLC患者实施术前新辅助化疗可提高手术切除率,并延长生存期,值得临床推广应用.

Objective To analyze the clinical efficacy of neoadjuvant chemotherapy in patients with stageⅢA non-small cell lung cancer (NSCLC). Methods From March 2008 to October 2015, there were 92 cases of stageⅢA NSCLC patients received 2 cycles of neoadjuvant chemotherapy and underwent radical surgery for lung cancer 3-4 weeks late ( observation group) , and another group of 65 cases of stage ⅢA NSCLC patients ( control group) underwent surgery for lung cancer without preoperative chemotherapy. The clinical data as well as early and meddle term surgical outcome of both groups were analyzed retrospectively. Results The neoadjuvant chemotherapy effective rate was 73. 9％ in the observation group. All surgeries for lung cancer patients were undertaken either with video-assisted thoracotomy or traditional thoracotomy. No operative mortality and the postoperative pathology findings were in accordance with NSCLC. The bleed-ing amount and operation time of two groups were similar; the resection rate of the observation group was greater than that of the control group. All patients were followed up at least 3 years, and the 2 years and 3 years survival rate of the observation group was slightly higher than that of the control group. Conclusions Preoperative neoadjuvant chemotherapy in patients with NSCLC can improve the resection rate and prolong the survival time, which is worthy of clinical application.