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目的 评价新辅助化疗改善ⅢA期非小细胞癌(NSCLC)手术切除率和生存期的作用。方法 42例ⅢA期NSCLC患者随机被分为两组,新辅助化疗组:接受2个周期的化疗后手术。单独手术组:确诊后直接手术。两组患者手术后均接受4个周期的化疗。结果 化疗的总有效率42.9％,其中部分缓解率38.1％,完全缓解率4.8％。化疗的毒副反应轻微,主要表现为胃肠道反应和骨髓抑制。接受新辅助化疗患者的手术切除率为95.8％(n=20),完全性切除率 52.4％(n=11),单独手术患者的手术切除率和完全性切除率分别为66.7%(n=14)和28.6%(n=6),两组比较差异有显著性意义(P<0.05％),无患者死于手术。新辅助化疗组患者的中位生存期(24.6％个月)明显长于单独手术组(10.8个月,P<0.05)。新辅助化疗组的2年生存率(57.1％)亦高于单独手术组(28.6％,P<0.05)。结论 新辅助化疗能够改善ⅢA期 NSCLC患者的手术切除率,延长中位生存期,增加 2年生存率。
Objective To evaluate the effect of neoadjuvant chemotherapy on the surgical resection rate and survival of stage Ⅲ A non-small cell carcinoma (NSCLC). Methods Forty-two patients with stage ⅢA NSCLC were randomly divided into two groups. Neoadjuvant chemotherapy group received two cycles of postoperative chemotherapy. Surgical group alone: diagnosed after direct surgery. Both groups received 4 cycles of chemotherapy after surgery. Results The total effective rate of chemotherapy was 42.9%, of which partial response rate was 38.1% and complete response rate was 4.8%. Toxicity of chemotherapy is mild, mainly for gastrointestinal reactions and bone marrow suppression. Surgical resection rate was 95.8% (n = 20), complete resection rate was 52.4% (n = 11), and surgical resection rate and complete resection rate were 66.7% (n = 14) ) And 28.6% (n = 6) respectively. There was a significant difference between the two groups (P <0.05%). No patient died of surgery. The median survival time (24.6% months) in the neoadjuvant chemotherapy group was significantly longer than that in the single surgery group (10.8 months, P <0.05). The 2-year survival rate of the neoadjuvant chemotherapy group (57.1%) was also higher than that of the solitary surgery group (28.6%, P <0.05). Conclusion Neoadjuvant chemotherapy can improve the surgical resection rate, prolong the median survival time and increase the 2-year survival rate in patients with stage Ⅲ A NSCLC.