术前单疗程化疗治疗Ⅲ_A期非小细胞肺癌的临床研究  

Clinical study of 1 cycle preoperative chemotherapy in treatment of stage Ⅲ_A non-small cell lung cancer.

作　　者：张泽峰[1] 王瑞[1] 姚继方[1] 高峰[1] 王增林[1] 郭杨[1] 

机构地区：[1]河北医科大学第四医院胸外科,石家庄050011

出　　处：《中国综合临床》2006年第1期10-12,共3页Clinical Medicine of China

摘　　要：目的探讨术前单疗程化疗加外科手术治疗ⅢA期非小细胞肺癌的可行性和毒性反应,同时评价其有效性以及对病期、切除率和生存率的影响。方法对166例ⅢA期非小细胞肺癌进行前瞻性随机对照试验,试验组(术前化疗组)和对照组各83例;前者进行术前化疗1个疗程,其中鳞癌44例以CAP方案,腺癌39例以FAD方案治疗,化疗结束10～14d后接受手术;对照组直接行手术治疗。两组均在术后行4～6次化疗。结果试验组化疗的有效率为56.7%(47/83),病期下调率36.1%(30/83)。手术切除率和根治性切除率试验组和对照组分别为92.8%(77/83)、80.7%(67/83)和85.5%(71/83)、66.3%(55/83),两组比较差异均有显著性(均为P<0.05)。术后1、2年生存率试验组和对照组分别为93.9%(78/83)、77.1%(64/83)、79.9%(58/83)和84.3%(70/83)、62.7%(52/83)。两组2年生存率比较差异有显著性(P<0.05)。两组手术并发症和病死率比较差异均无显著性。结论术前单疗程化疗安全、有效,能降低ⅢA期非小细胞肺癌的病期,提高手术切除率尤其是根治性切除率及术后生存率,同时并不增加并发症发生率和病死率。Objective To explore the feasibility and toxic effect of the muhimodality treatment including surgical intervention and 1 cycle preoperative chemotherapy for stage ⅢA a non-small cell lung cancer （ NSCLC ） and to evaluate its effects on tumor response,resection rate,and survival rate. Methods A prospectively randomized trial was conducted in 166 cases with stage ⅢA NSCLC. The trial group （ preoperative chemotherapy group, n = 83 ） underwent 1 cycle chemotherapy preoperatively, including 44 cases of adenoeareinoma treated with CAP regimen and 39 cases of squamous cancer treated with FAD regimen, all of whom received surgical treatment 10-14days after chemotherapy. The control group was treated surgically. 4-6 times chemotherapies were conducted postoperatively in both groups. Results The responsive rate was 56.7% （ 47/83 ） and tumor downstaging rate was 36.1% （ 30/83 ） in trial group. Surgical resection rates and radical resection rates were 92.8% （ 77/83 ） vs. 85.5% （ 71/83 ） and 80.7 （67/83） vs. 66.3% （52/83） in trial group and control group, with significant difference between groups （ P 〈 0.05 ）. The 1 - and 2- year survival rate were 93.9% （ 78/83 ） vs. 84.3% （ 70/83 ） and 77.1% （ 64/83 ） vs. 62.7%（52/830 ） in trial group and control group. Significant difference existed in 2-year survival rate between groups （ P 〈 0.05 ）. However, there was no significant difference in complication and mortality. Conclusion 1 cycle preoperative chemotherapy is safe and effective in treatment of stage ⅢA non-small cell lung cancer,which can re, duce disease course, increase surgical resection rate especially radical resection rate and postoperative survival rate, but can not increase complication and mortality concurrently.

关 键 词：肺癌 术前化疗 病期下调 手术切除率 术后生存率 

分 类 号：R734.2[医药卫生—肿瘤]