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非小细胞肺癌(NSCLC)占肺癌的80%以上,其恶性程度低于小细胞肺癌(SCLC),治疗以手术为主.由于肿瘤生物学特征,手术后常因局部复发或远道转移导致治疗失败.尤以Ⅰ期NSCLC术后是否需要治疗尚乏统一意见.本文对上海市胸科医院、上海市第一肺科医院、上海市第二肺科医院、上海医科大学附属肿瘤医院等收治的124例Ⅰ期NSCLC患者进行前瞻性多中心的随机研究,试图探索出较好的手术后辅助治疗方案.材料和方法从1991年初～1994年底,上海市胸科医院等4家医院统一规定,要求患者属上海户籍,便于随访.按前瞻性设计方案执行,术前行严格的分期检查,包括正、侧位X线胸片,胸、脑部CT,腹部CT或B超、全身骨骼同位素扫描及全身详细体检,剔除Ⅰ期以外的NSCLC患者.术前常规检查心、肺、肝、肾等功能属正常者,年龄≤70岁,Karnofsky评分≥80分.凡符合上述条件者为手术指征.临床分期按1989年国际抗癌联盟制订的标准.手术医师均统一了手术操作方法,必需切开纵隔,摘除肉眼可见的胸内各组淋巴结,按组标明其部位送病理检查.患者均为手术能完全切除者.术后采用信封抽签法分成术后化疗组和非化疗组,后者再次随机分成不治疗组和免疫治疗组.术后辅助治疗均在术后1月开始,术后化疗组以顺铂60mg/m~2联合丝裂霉系(MMC)6mg/m~2和阿霉素(ADM)
Non-small cell lung cancer (NSCLC) accounts for more than 80% of lung cancer, and its degree of malignancy is lower than that of small cell lung cancer (SCLC). The treatment is mainly based on surgery. Due to the biological characteristics of the tumor, the treatment often leads to treatment failure due to local recurrence or distant metastasis. In particular, there is no consensus on the need for treatment after the first stage of NSCLC. This article treats 124 patients admitted to Shanghai Chest Hospital, Shanghai First Pulmonary Hospital, Shanghai Second Pulmonary Hospital, and Shanghai Medical University Affiliated Tumor Hospital. A prospective, multicenter, randomized study of patients with stage I NSCLC was attempted to explore better postoperative adjuvant therapy options. Materials and methods were standardized at four hospitals including Shanghai Chest Hospital from the beginning of 1991 to the end of 1994. Shanghai is a household register for easy follow-up. Performed according to a forward-looking design plan. Strict staging before surgery, including chest X-ray, chest, brain CT, abdomen CT or B ultrasound, whole body bone isotope scan and whole body Detailed physical examination, except for patients with stage I NSCLC. Preoperative routine examination of heart, lung, liver, kidney and other functions is normal, age ≤ 70 years, Karnofsky score ≥ 80 points. All those who meet the above conditions are surgical indications. According to the standards set by the International Anticancer Union in 1989, surgeons have unified surgical procedures. The mediastinum must be incised and the naked lymph nodes in the chest must be removed by naked eyes. Completely resected patients were divided into postoperative chemotherapy group and non-chemotherapy group by envelope lotion. The latter was randomly divided into non-treatment group and immunotherapy group. Postoperative adjuvant therapy was started at 1 month after surgery. Cisplatin 60mg/m~2 Combined with Mitochondria (MMC) 6mg/m~2 and Adriamycin (ADM)