CAJ | 학술논문

目的评价新辅助化疗改善ⅢA期非小细胞癌(NSCLC)手术切除率和生存期的作用.方法 42例ⅢA期NSCLC患者随机被分为两组,新辅助化疗组:接受2个周期的化疗后手术.单独手术组:确诊后直接手术.两组患者手术后均接受4个周期的化疗.结果化疗的总有效率42.9%,其中部分缓解率38.1%,完全缓解率4.8%.化疗的毒副反应轻微,主要表现为胃肠道反应和骨髓抑制.接受新辅助化疗患者的手术切除率为95.8%(n＝20),完全性切除率52.4%(n＝11),单独手术患者的手术切除率和完全性切除率分别为66.7%( n＝14)和28.6%(n＝6),两组比较差异有显著性意义(P<0.05),无患者死于手术.新辅助化疗组患者的中位生存期(24.6%个月)明显长于单独手术组(10.8个月,P<0.05).新辅助化疗组的2年生存率(57.1%)亦高于单独手术组(28.6%,P<0.05).结论新辅助化疗能够改善ⅢA期NSCLC患者的手术切除率,延长中位生存期,增加2年生存率.
목적 평개신보조화료개선ⅢA기비소세포암(NSCLC)수술절제솔화생존기적작용.방법 42례ⅢA기NSCLC환자수궤피분위량조,신보조화료조:접수2개주기적화료후수술.단독수술조:학진후직접수술.량조환자수술후균접수4개주기적화료.결과 화료적총유효솔42.9%,기중부분완해솔38.1%,완전완해솔4.8%.화료적독부반응경미,주요표현위위장도반응화골수억제.접수신보조화료환자적수술절제솔위95.8%(n＝20),완전성절제솔52.4%(n＝11),단독수술환자적수술절제솔화완전성절제솔분별위66.7%( n＝14)화28.6%(n＝6),량조비교차이유현저성의의(P<0.05),무환자사우수술.신보조화료조환자적중위생존기(24.6%개월)명현장우단독수술조(10.8개월,P<0.05).신보조화료조적2년생존솔(57.1%)역고우단독수술조(28.6%,P<0.05).결론 신보조화료능구개선ⅢA기NSCLC환자적수술절제솔,연장중위생존기,증가2년생존솔.
Objective To assess the effect of neoadjuvant chemotherapy on surgical resectibility and survival in patients with stage ⅢA non small cell lung cancer (NSCLC). Methods 42 patients with stage ⅢA NSCLC were randomized to receive either two cycles chemotherapy followed by surgery (neoadjuvant chemotherapy group) or surgery alone (surgery alone group). All patients received four cycles chemotherapy after surgery. Results The overall response to chemotherapy was 42.9% (38.1% partial response and 4.8% complete response). Toxicity of chemotherapy was minor and consisted mainly of gastroenterological side effects and myelosuppression. Patients treated with neoadjuvant chemotherapy had estimated surgical resection rate of 95.2% (n=20) and a complete resection rate in 52.4% (n=11) compared to 66.7% (n=14) and 28.6% (n=6) respectively, for patients with surgery alone (P<0.05). None of the patients died from the operation. The median survival was 24.6 months in the neoadjuvant chemotherapy group as compared to only 10.8 months in the surgery alone group (P<0.05). The 2-year survival rate was 57.1% in the chemotherapy group as compared to 28.6% in the surgery alone group (P<0.05).Conclusion Neoadjuvant chemotherapy improves the surgical resectibility and increases the median survival and 2-year survival rate of patients with stage ⅢA NSCLC.