ⅢA期非小细胞肺癌患者新辅助化疗后胸腔镜肺叶切除效果  

Treatment experience of patients with stage IIIA non-small cell lung cancer after neoadjuvant chemotherapy in VATS lobectomy

作　　者：牟志民[1] 毛广显 谢远财[1] 彭旭兴[1] 乌达[1] 

机构地区：[1]北京大学深圳医院胸外科,广东深圳518036

出　　处：《安徽医学》2015年第4期410-412,共3页Anhui Medical Journal

基　　金：深圳市科技计划项目(JCYJ20140415162338820);深圳市医疗卫生科研项目(201302068)

摘　　要：目的探讨ⅢA期非小细胞肺癌(NSCLC)患者新辅助化疗后胸腔镜肺叶切除治疗的疗效。方法收集30例ⅢA期NSCLC患者术前进行新辅助化疗为观察组,同期直接手术的ⅢA期NSCLC患者25例作为对照组。观察组患者术前采用紫杉醇脂质体+奈达铂方案化疗2个周期,对照组术前未进行化疗,术后行辅助化疗。观察两组手术切除率、术后并发症及预后情况。结果1观察组手术切除率为93.3%,对照组手术切除率为80.0%,两组比较差异有统计学意义(P<0.05)。2观察组并发症发生率为23.3%,对照组发生率为28.0%,两组比较差异无统计学意义(P>0.05)。3观察组1年生存率为86.7%,对照组为68.0%;观察组3年生存率为63.3%,对照组为52.0%;两组1、3年生存率比较差异有统计学意义(P<0.05)。结论新辅助化疗能有效提升NSCLC手术切除率,有效延长患者生存期,并且化疗不良反应均在可控范围之内。因此,ⅢA期的NACLC患者术前新辅助化疗加手术方案值得临床推广。Objective To investigate the curative effect of patients with stage IIIA non-small cell lung cancer (NSCLC)after neoad-juvant chemotherapy in VATS lobectomy. Methods Thirty cases of patients with stage ⅢA NSCLC preoperative neoadjuvant chemotherapy after surgery were collected from Jan. 2008 to Jun. 2011 in the hospital as the observation group,at the same time 25 cases of direct surgical patients with stage ⅢA NSCLC were collected as control group. The observation group received preoperatively paclitaxel liposome plus Nida's platinum,with 2 cycles,while the control group had no preoperative chemotherapy,and the two groups all had postoperative adjuvant chemotherapy. The operative resection rate,complications and prognosis in the two groups were observed and compared. Results ①The op-erative resection rate was 93. 3% in observation group,and 80. 0% in control group,and there was statistically significant difference between the two groups(P<0. 05).②The complication rate was 23. 3% in observation group,and 28. 0% in control group,and there was no statisti-cally significant difference between the two groups (P>0. 05).③The 1-year survival rate was 86. 7% in observation group,and 68. 0% in control group;the 3-year survival rate was 63. 3% in observation group,and 52. 0% in control group. There were statistically significant differences in comparison of the 1-year,3-year survival rate between the two groups(P<0. 05). Conclusion Neoadjuvant chemotherapy can effectively promote NSCLC resection rate,prolong the patient's survival,and the adverse reactions of chemotherapy are manageable. Therefore,preoperative neoadjuvant chemotherapy plus surgery is worth the clinical promotion in treating patients with stage ⅢA NACLC.

关 键 词：非小细胞肺癌 ⅢA期 新辅助化疗 肺叶切除 

分 类 号：R734.2[医药卫生—肿瘤]