术前贝伐珠单抗联合含铂方案新辅助化疗对ⅢA-N2期肺癌手术患者预后的影响  

Effect of preoperative bevacizumab combined with platinum-containing neoadjuvant chemotherapy on the prognosis of patients with stageⅢA-N2 lung cancer surgery

作　　者：谢宁 曲言正 姜海鹏 杨鑫晶 XIE Ning;QU Yanzheng;JIANG Haipeng;YANG Xinjing(Department of Cardiothoracic Surgery,Yantai Yantai Mountain Hospital,Yantai 264000,China;Department of Surgery,Mouping District Hospital of Traditional Chinese Medicine,Yantai 264100,China;Department of Pain,Yantai Yantai Mountain Hospital,Yantai 264000,China;Department of Surgery,Community Health Service Center,Wuning Street,Mouping District,Yantai 264118,China)

机构地区：[1]烟台市烟台山医院心胸外科,山东烟台264000 [2]烟台市牟平区中医医院外科,山东烟台264000 [3]烟台市烟台山医院疼痛科,山东烟台264000 [4]烟台市牟平区武宁街道社区卫生服务中心外科,山东烟台264118

出　　处：《中国肿瘤外科杂志》2022年第4期371-375,共5页Chinese Journal of Surgical Oncology

基　　金：山东省医药卫生科技发展计划项目(2019WS318)。

摘　　要：目的分析术前应用贝伐珠单抗联合含铂方案新辅助化疗对ⅢA-N2期肺癌手术患者预后的影响。方法选取烟台市烟台山医院2016年6月至2018年6月收治的ⅢA-N2期肺癌手术患者112例,按治疗方式不同分为研究组(56例)与对照组(56例)。研究组术前接受贝伐珠单抗及含铂方案新辅助化疗(培美曲塞+卡铂)治疗后若病情无明显进展或转移,行手术治疗,对照组术前仅接受含铂方案新辅助化疗(培美曲塞+卡铂)方案治疗后若病情无明显进展或转移,行手术治疗。比较两组临床疗效、不良反应发生情况,手术率、手术情况(手术时间、术中出血量、术后住院时间)及远期疗效[2年无进展生存时间(PFS)、2年总生存时间(OS)]。结果研究组客观缓解率(ORR)高于对照组(71.43%vs.50.00%,P<0.05);总两组不良反应发生率比较差异无统计学意义(P>0.05);两组患者手术率及接受手术患者的手术时间、术中出血量、术后住院时间及术后吻合口瘘发生率比较差异无统计学意义(P>0.05);随访至2021年1月,研究组2年PFS及2年OS明显优于对照组,差异均有统计学意义(χ^(2)=3.258、4.156,P<0.05)。结论术前贝伐珠单抗联合含铂方案新辅助化疗对ⅢA-N2期肺癌手术患者具有良好的近期及远期疗效,且不增加不良反应发生率。Objective To analyze the effect of preoperative application of bevacizumab combined with platinum-containing neoadjuvant chemotherapy on the prognosis of patients with stageⅢA-N2 lung cancer surgery.Methods A total of 112 patients undergoing surgery for stage IIIA-N2 lung cancer admitted to the hospital from June 2016 to June 2018 were selected and divided into study group(56 cases)and control group(56 cases)according to different treatment methods.The study group received Bevac before surgery,the neoadjuvant chemotherapy(pemetrexed+carboplatin)of virizumab and platinum-containing regimen received surgical treatment,and the control group received only the neoadjuvant platinum-containing chemotherapy(pemetrexed+carboplatin)regimen before surgery and then received surgery treatment.Comparison of clinical efficacy,occurrence of adverse reactions,operation status of the two groups(operation time,intraoperative blood loss,postoperative hospital stay)and long-term efficacy[2-year progression-free survival rate(PFS),2-year overall survival rate(OS)].Results The objective response rate(ORR)of the study group was higher than that of the control group(P<0.05).There was no statistical difference in the total incidence of adverse reactions between the two groups(P>0.05).After neoadjuvant chemotherapy,50 patients in the research group received surgical treatment,and 45 patients in the control group received surgical treatment.The surgical rate of patients in the two groups and the operating time,intraoperative blood loss,postoperative hospital stay,and postoperative anastomosis of the patients in the two groups were compared.There was no significant difference in the incidence of fistula(P>0.05).Follow-up until January 2021,the difference in 2-year PFS survival curve and 2-year OS survival curve between the two groups was statistically significant(χ2=3.258,4.156,P<0.05).Conclusions Bevacizumab combined with platinum-containing neoadjuvant chemotherapy has good short-term and long-term curative effects for patients with sta

关 键 词：ⅢA-N2期肺癌 贝伐珠单抗 含铂方案新辅助化疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]