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目的 探讨新辅助化疗在综合治疗Ⅲ期非小细胞肺癌的方法中合理性及可行性。方法 综合分析 1997年 5月～ 2 0 0 0年 8月期间新辅助化疗Ⅲ非小细胞肺癌 2 6例临床资料。结果 术前化疗CR2例、PR13例、SD11例 ,总有效率 6 0 % ,术后病理 :1例未找到癌灶 ,纵隔淋巴结癌细胞阳性 4例 ,3、5年生存率分别为 6 9 2 % ( 18/2 6 )、30 8% ( 8/2 6 )。结论 新辅助化疗使Ⅲ期非小细胞肺癌的TNM分期提前 ,提高了切除率和根治率 ,同时清除微小转移灶以及使原发灶和纵隔淋巴结内微小血管阻塞而避免了因手术创伤及挤压等因素造成癌栓脱落形成术后转移灶 ,从而延长了术后无瘤生存期及降低了远处转移率 ,并可明确化疗的个体化方案指导后续治疗 ,提高了疗效及 5年生存率。明显优于术后化疗及直接手术治疗 ,应为Ⅲ期非小细胞肺癌治疗的首选
Objective To investigate the rationality and feasibility of neoadjuvant chemotherapy in the comprehensive treatment of stage Ⅲ non-small cell lung cancer. Methods The clinical data of 26 patients with neoadjuvant chemotherapy Ⅲ non-small cell lung cancer from May 1997 to August 2000 were analyzed. Results The preoperative chemotherapy CR2, PR13, and SD11 showed a total effective rate of 60%. Postoperative pathology showed no tumor in one case, positive cases of mediastinal lymph node carcinoma in 4 cases, and the 3 and 5 year survival rates were 6 9 2 % (18/2 6), 30 8% (8/2 6). Conclusion Neoadjuvant chemotherapy advances the TNM staging of stage Ⅲ non-small cell lung cancer, improves the resection rate and cure rate, and simultaneously removes the micrometastases and occludes the tiny blood vessels in the primary tumor and mediastinal lymph nodes to avoid the trauma and compression And other factors cause the formation of postoperative metastatic tumor thrombus shed, which extended the postoperative tumor-free survival and reduce the distant metastasis rate, and chemotherapy can be clear individualized follow-up treatment guidelines to improve the efficacy and 5-year survival rate. Obviously superior to postoperative chemotherapy and direct surgical treatment, should be the first choice for the treatment of non-small cell lung cancer