【作者】 彭忠民； 刘奇；

【Author】 Peng Zhong-M in Liu Qi Department of Thoracic Surgery ,Tumor center,Shandong Provincial Hospital, Jinan, Shandong China

【机构】 山东省立医院胸外科；

【摘要】 目的:本研究旨在探索新辅助化疗对Ⅲ期非小细胞肺癌预后的影响。方法:对87例Ⅲ期非小细胞肺癌患者进行前瞻性随机对照试验,其中45例行新辅助化疗,42例直接手术作为对照。新辅助化疗组术前行1～2周期化疗,化疗后3 周左右再手术治疗。结果:新辅助化疗组总的有效率为46．7％ (21／45)。COX回归分析显示,有效的新辅助化疗对生存有保护作用(P=0．015,<0．05)。新辅助化疗组1,3年生存率及中位生存时间分别为68．4％,37．2％,20个月,直接手术组分别为65．2％,29．8％,18个月,两组比较无明显差异(P> 0．05)。化疗有效的患者(21例)1,3年生存率及中位生存时间分别为78．2％,52．4％,31个月,化疗无效者(24例)分别为62．1％,20．3％,14个月,两组间有显著差异(P=0．044<0． 05)。结论:对Ⅲ期非小细胞肺癌患者而言,新辅助化疗加手术较直接手术的患者在生存率上的提高主要是针对化疗有效者,对化疗无效的患者不利。应结合患者的具体情况有选择地行新辅助化疗以改善预后。更多还原

【Abstract】 Objective: This study was designed to investigate the effect of neoadjuvant chemotherapy followed by surgery on prognosis in patients with stage HI NSCLC. Methods: Eight-seven patients were randomly divided into group A(45 cases, neoadjuvant chemotherapy group) and group B(42 cases,control group without neoadjuvant chemotherapy).The patients in group A were given 1 or 2 cycles of neoadjuvant chemotherapy first, then operations were performed in 3 weeks or so after chemotherapy. Results: The tumor response to neoadjuvant chemotherapy was 46.7%( 21/45 )in group A.Cox Regression told us that responding neoadjuvant chemotherapy was a protecting fact for survival(P=0.015). The 1 and 3-year survival rate and median survival time in group A and group B was 68.4%, 37.2%, 20 months and 65.2%, 29.8%, 18 months respectively. In group A, we got two classes according to response to chemotherapy, responding one and non-responding one, the 1 and 3-year survival rate and median survival time was32.1%, 67.8%, 21 months and 49.1%, 69.1%, 25 months respectively, The difference is significant(P=0.044). Conclusion: In stage Ⅲ NSCLC patients, prognosis was better in responding patients who received neoadjuvant chemotherapy followed by surgery than those who received surgery without neoadjuvant chemotherapy.The neoadjuvant chemotherapy was harm to those who had no response to chemotherapy. We should select patients to give neoadjuvant chemotherapy according to the possibility of response.更多还原