新辅助免疫治疗联合化疗后袖式切除术治疗肺癌的回顾性队列研究  

Efficacy of sleeve lobectomy after neoadjuvant chemoimmunotherapy in lung cancer:A retrospective cohort study

作　　者：王峥[1] 王猛[1] 孙大强 WANG Zheng;WANG Meng;SUN Daqiang(Department of Thoracic Surgery,Tianjin Chest Hospital Affiliated to Tianjin University,Tianjin,300222,P.R.China)

机构地区：[1]天津大学附属天津市胸科医院胸外科,天津300222

出　　处：《中国胸心血管外科临床杂志》2024年第12期1775-1780,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：天津市医学重点专科建设项目资助(TJYXZDXK-018A)。

摘　　要：目的探究新辅助免疫治疗联合化疗后行袖式切除术的围手术期安全性。方法回顾性分析天津市胸科医院胸外科2020年1月1日—2022年10月1日接受袖式切除手术患者的临床资料。根据是否接受新辅助免疫治疗联合化疗将患者分为新辅助治疗组和单纯手术组。比较两组患者的临床资料。结果共纳入22例患者,其中男19例、女3例,中位年龄63岁。新辅助治疗组7例,单纯手术组15例。两组患者手术时间、术中出血量、淋巴结清扫、术后带管时间和术后引流量差异无统计学意义(P>0.05)。新辅助治疗组1例患者因支气管动脉出血导致二次开胸探查止血,2例患者伤口感染,1例患者术前发生免疫相关性肺炎,1例患者拟行术后辅助治疗前出现免疫相关性肺炎。新辅助治疗组患者的术后病理结果显示1例(14.3%)患者病理学完全缓解,3例(42.9%)表现为主要病理学缓解。结论新辅助免疫治疗联合化疗会导致并发症,包括手术相关并发症以及免疫相关性并发症,但术后病理缓解程度同样显著改善。整体来看,新辅助免疫治疗联合化疗后行袖式切除术可以作为肺癌患者的一项治疗选择。Objective To evaluate the outcomes of sleeve resection following neoadjuvant chemoimmunotherapy for lung cancer.Methods The clinical data of patients diagnosed with lung cancer and underwent sleeve lobectomy surgery at Tianjin Chest Hospital were retrospectively analyzed.Patients were divided into two groups:a neoadjuvant treatment group and a surgery alone group.The clinical data of two groups were compared.Results Finally 22 patients were collected,including 19 males and 3 females with a median age of 63 years.There were 7 patients in the neoadjuvant treatment group,and 15 patients in the surgery alone group.There was no statistical difference in surgical time,intraoperative bleeding,lymph node dissection,postoperative catheterization time,or postoperative drainage volume between the two groups(P>0.05).In the neoadjuvant treatment group,1 patient had a second thoracotomy exploration for hemostasis due to bronchial artery bleeding,2 patients had wound infection,1 patient had immuneassociated pneumonia before surgery,and 1 patient had immune-associated pneumonia before postoperative adjuvant therapy.Postoperative pathological results of patients in the neoadjuvant treatment group showed that 1(1/7,14.3%)patient had pathological complete response,and 3(3/7,42.9%)patients achieved major pathological response.Conclusion Neoadjuvant chemoimmunotherapy can lead to complications,including operation-related complications and immunotherapy-related complications.However,the degree of postoperative pathological remission is also significantly improved.Overall,sleeve resection following neoadjuvant chemoimmunotherapy can be considered as a treatment option for patients with lung cancer.

关 键 词：肺癌 袖式切除术 新辅助免疫治疗联合化疗 

分 类 号：R734.2[医药卫生—肿瘤]