Systematic review and meta-analysis of Chinese herbal medicine as adjuvant treatment in advanced non-small cell lung cancer patients

IntroductionWhether combining Chinese herbal medicines (CHMs) and chemotherapy to treat patients with advanced non-small-cell lung cancer (NSCLC) has clinical benefits has yet to be confirmed. A meta-analysis was performed to address the efficacy of CHM in patients with advanced NSCLC.MethodsSeven databases, including PubMed, MEDLINE, Cochrane Library, Embase, CINAHL Plus with Full Text (EBSCO), WANFANG DATA and the Chinese National Knowledge Infrastructure (CNKI), were systematically searched for available literature through March10, 2020. A meta-analysis was conducted to generate combined risk ratios(RRs) with 95 % confidence intervals (CIs) for objective response rates (ORRs), disease control rates (DCRs), and 1-year overall survival (OS) rates, and a random-effects model was used to estimate the standardized mean differences (SMDs) with 95 % CI for quality or life (QOL), median survival time (mST) and progression-free survival (PFS).ResultsReports of 14 randomized controlled trials involving 1451 patients were included in the analysis. Among them, 739 patients received CHMs, and 712 patients received chemotherapy alone. The ORR (RR = 1.37, 95 % CI [1.20‐1.58], p = .000), DCR (RR = 1.13, 95 % CI [1.07‐1.21], p = 0.000), QOL (SMD = 1.47; 95 % CI [0.30–2.64]; p = 0.014), mST (SMD = 1.62; 95 % CI [1.15‐2.08];p = .000), and 1-year OS rate (RR = 1.24, 95 % CI [1.05‐1.47], p = 0.01) were higher in patients with NSCLC who received CHMs than in those who received only chemotherapy. However, the CHM group was not found to have a higher median PFS (SMD = 1.27, 95 % CI [-0.22‐2.78], p = .095) than the chemotherapy group. Publication bias for ORR and DCR was indicated by funnel plot. For the efficacy endpoint, no evidence of a lack of robustness was found, according to the sensitivity analysis. These results must be interpreted with caution due to differences in the designs of the trials and patients’ characteristics, and also due to the presence of missing data.ConclusionsOur study found that higher ORR, DCR, QOL, mST and 1-year OS rate were associated with CHM use as an adjuvant to chemotherapy. Although these results require further confirmation, CHMs apparently have potential therapeutic value for patients with advanced NSCLC.     

非小细胞肺癌的靶向治疗

肺癌的发病率和死亡率在全球恶性肿瘤中居首位。其中,非小细胞肺癌（NSCLC）占80%~85%。绝大多数NSCLC在临床确诊时正处于复发或转移性的晚期阶段,化疗是这部分人群的主要治疗手段。但是,作为标准一线治疗的含铂两药联合化疗方案已进入平台期,无进展生存期（PFS）为4~6个月,总生存期（OS）仅为8~10个月。近年来,靶向药物的临床应用让人们看到了跨越这一平台的希望和曙光,靶向治疗作为一支生力军正逐渐登上非小细胞肺癌综合治疗的历史舞台。     

非小细胞肺癌患者化疗前后生活质量及焦虑情绪的影响因素分析

目的 通过分析比较非小细胞肺癌患者化疗前后的生活质量及焦虑情绪的变化,探讨化疗对于肺癌患者生活质量及焦虑情绪的影响.方法 采用EORTC QLQ-C30及Zung焦虑自评量表(SAS)对64例非小细胞肺癌患者于化疗前、化疗2周期后、化疗4周期后进行临床疗效评估.结果 化疗前生活质量方面疲乏、呼吸困难项目得分较高,伴焦虑情绪的患者占58％,平均SAS得分为(49.7±5.8)分;焦虑症状与失眠有相关性;化疗2周期后,患者呼吸困难得分较前下降,食欲丧失、失眠得分升高,与化疗前比较有显著差异;化疗4周期后患者角色、躯体、情绪、社会功能得分明显下降,恶心呕吐、便秘、食欲不振及经济困难条目得分明显上升,与化疗前2周期相比有显著差异;焦虑症状与疲乏、便秘及失眠相关.结论 非小细胞肺癌在化疗过程中,部分患者躯体症状得到缓解,但焦虑情绪明显增加,生命质量有所下降,因此护理人员应当及时准确评价患者生活质量及情绪改变并针对性地加强护理措施,提高患者生活质量.     

康莱特注射液辅助治疗中晚期非小细胞肺癌的效果观察

目的 观察康莱特注射液辅助治疗中晚期非小细胞肺癌的临床效果.方法 将61例晚期非小细胞肺癌患者随机分为治疗组31例和对照组30例,两组均给予综合治疗,治疗组在此基础上加用康莱特注射液200 ml静脉滴注,观察两组生活质量疗效、疼痛缓解情况、临床疗效和不良反应等情况.结果 (1)生活质量疗效:治疗组改善20例(64.5％),稳定8例(25.8％),下降3例(9.7％);对照组分别为9例(30.0％),9例(30.0％),12例(40.0％),治疗组优于对照组(U=2.91,P＜0.01).(2)疼痛缓解情况:治疗组完全缓解、部分缓解、无变化、进展者分别为5例(16.1％),16例(51.6％),6例(19.4％),4例( 12.9％);对照组分别为2例(6.7％),9例(30.0％),11例(36.7％),8例(26.7％),治疗组优于对照组(U=2.32,P＜0.05).(3)临床疗效:治疗组部分缓解、稳定、进展者分别为12例(38.7％),14例(45.2％),5例(16.1％),对照组分别为8例(26.7％),8例(26.7％),14例(46.7％),治疗组优于对照组(U=2.04,P＜0.05).(4)不良反应:治疗组白细胞计数和胃肠道反应Ⅲ、Ⅳ度发生率分别为22.6％ (7/31)和19.4％ (6/31),而对照组分别为53.3％ (16/30)和46.7％ (14/30),差异均有统计学意义(x2值分别为6.139和5.161,P均＜0.05).结论 康莱特注射液联合治疗可提高晚期非小细胞肺癌临床疗效,减轻不良反应,保护免疫功能,提高患者生存质量.     

分阶段认知行为干预对非小细胞肺癌化疗患者自我感受负担及生存质量的影响

目的探讨分阶段认知行为对非小细胞肺癌化疗患者自我感受负担和生存质量的影响。方法选取2017年6月至2018年6月该院收治的非小细胞肺癌患者61例,随机分为观察组(31例)和对照组(30例)。两组患者确诊后均根据具体的治疗方案进行化疗,对照组患者在治疗期间接受常规临床护理模式,观察组在对照组的基础上增加阶段性认知行为干预。比较两组患者干预前后自我感受负担和生存质量情况。结果干预后,观察组患者中度自我感受负担、重度自我感受负担明显下降,与干预前比较差异有统计学意义(P<0.05);观察组中度自我感受负担、重度自我感受负担低于对照组,差异有统计学意义(P<0.05)。干预后,观察组患者角色功能、情绪功能、认知功能、社会功能评分高于干预前,差异有统计学意义(P<0.05);观察组患者情绪功能、认知功能、社会功能评分高于对照组,差异有统计学意义(P<0.05)。结论分阶段认知行为干预可有效减轻非小细胞肺癌化疗患者自我感受负担,提高患者生存质量,可作为NSCLC患者的临床护理措施。     

培美曲塞维持治疗在晚期非小细胞肺癌中的疗效分析

目的探讨不同的一线治疗方案对培美曲塞单药维持治疗疗效的影响。方法选取41例行培美曲塞联合顺铂（PC组）和29例吉西他滨联合顺铂（GC组）一线治疗的ⅢB/Ⅳ期非鳞状细胞NSCLC患者,疾病得到控制者进入培美曲塞维持治疗。结果在一线治疗中,PC组和GC组有效率（χ2=0.0442,P=0.8332）和疾病控制率（χ2=0.0049,P=0.9439）均无显著性差异。而在维持治疗阶段,2组的有效率（χ2=0.0601,P=0.8059）、疾病控制率（χ2=0.0045,P=0.9464）和无进展生存期（χ2=1.904,P=0.168）均亦无显著性差异,但PC组患者的总生存期显著长于GC组的[15.4月∶11.6月（χ2=5.243,P=0.022）]。结论不同的一线治疗方案对培美曲塞单药维持治疗的近期疗效无影响,但在远期疗效上有差异。     

Traditional Chinese Medicine treatment as maintenance therapy in advanced non-small-cell lung cancer: A randomized controlled trial

ObjectivesMaintenance therapy for patients with advanced non-small-cell lung cancer (NSCLC) is an increasingly hot topic in the field of clinical NSCLC research. This study aimed to evaluate the effects of Traditional Chinese Medicine (TCM) treatment as maintenance therapy on time to progression (TTP), quality of life (QOL), overall survival (OS) and 1-year survival rate in patients with advanced NSCLC.MethodsThis study was conducted as a randomized, controlled, open-label trial. 64 non-progressive patients who responded to initial therapy were randomized 1:1 to the TCM arm (treated with herbal injection (Cinobufacini, 20 ml/d, d1–d10), herbal decoction (d1–d21) and Chinese acupoint application (d1–d21), n = 32) or to the chemotherapy arm (treated with pemetrexed (non-squamous NSCLC, 500 mg/m², d1), docetaxel (75 mg/m², d1) or gemcitabine (1250 mg/m², d1 and d8), n = 32). Each therapy cycle was 21 days. They were repeated until disease progression, unacceptable toxicity, or until the patients requested therapy discontinuation. The primary end point was TTP; the secondary end points were QOL, OS and 1-year survival rate. “Intention-to-treat” analysis included all randomized participants.ResultsTCM treatment prolonged median TTP for 0.7 months compared with chemotherapy, but it was not statistically significant (3.0 months vs. 2.3 months, P = 0.114). Median OS time for TCM treatment did not offer a significant advantage over for chemotherapy (21.5 months vs. 18.8 months, P = 0.601). 1-year survival rate of TCM treatment significantly improved than that of chemotherapy (78.1% vs. 53.1%, P = 0.035). TCM treatment can significantly improve QOL when compared to chemotherapy as assessed by EORTC QLQ-C30 and EORTC QLQ-LC13 QOL instruments.ConclusionsTCM maintenance treatment had similar effects on TTP and OS compared with maintenance chemotherapy, but it improved patients' QOL and had higher 1-year survival rate. TCM Maintenance treatment is a promising option for advanced NSCLC patients without progression following first-line chemotherapy.     

康莱特联合吉非替尼对晚期非小细胞肺癌患者免疫功能和生活质量的影响

目的 评价康莱特联合吉非替尼对晚期非小细胞肺癌患者细胞免疫功能和生活质量的影响。方法 晚期非小细胞肺癌患者46例,依据治疗方法分为治疗组和对照组各23例,治疗组应用康莱特联合吉非替尼,对照组应用吉非替尼单药,2组均21d为1个周期。分别于治疗前、治疗2个周期后测定2组CD3、CD4、CD4/CD8和自然杀伤（natural killer,NK）细胞活性,并观察2组KPS评分和不良反应发生率。结果 治疗组治疗后CD3、CD4、CD4/CD8和NK细胞活性（（53.98±9.17）%、（35.89±7.96）%、1.69±0.49、（42.42±9.28）%）高于治疗前（（48.33±9.62）%、（30.92±8.67）%、1.35±0.62、（36.51±10.52）%）及对照组治疗后（（47.50±6.96）%、（29.30±8.60）%、1.26±0.57、（33.01±6.70）%）（P〈0.05）,对照组治疗前、后各指标比较差异无统计学意义（P〉0.05）;治疗组KPS评分改善＋稳定及体质量增加＋稳定百分率（82.6%、73.9%）高于对照组（52.2%、43.5%）（P〈0.05）;2组腹泻、皮疹发生率比较差异无统计学意义（P〉0.05）。结论 康莱特联合吉非替尼可提高晚期非小细胞肺癌患者的细胞免疫功能,改善患者生存质量,安全性好。     

中药清金化坚饮联合化疗对晚期非小细胞肺癌生存质量影响的临床观察

目的采用国际生存质量量表,评价中药清金化坚饮联合化疗对晚期非小细胞肺癌患者生存质量的影响,同时观察其对临床常见症状、体力状况Karnofsky评分、肿瘤标记物水平的影响。方法将40例晚期非小细胞肺癌患者随机分为2组,治疗组20例接受清金化坚饮联合GP方案治疗,对照组20例单纯接受GP方案化疗,28 d为1个治疗周期,共观察2个周期。采用EORTC QLQ-C43及FACT-L生存质量量表等疗效评价方法,进行近期疗效、生活质量等的对照观察。结果治疗后治疗组患者生存质量评分呈上升趋势,对照组呈下降趋势,治疗组患者在缓解临床症状、提高生存质量和体力状况、降低肿瘤标志物水平以及减轻化疗毒副反应方面优于对照组,经统计学分析,差异有统计学意义(P<0.05)。结论中药清金化坚饮治疗晚期非小细胞肺癌能够改善患者的生存质量,缓解临床症状,改善体力状况,一定程度上降低肿瘤标记物水平,增加和维持体重,值得临床推广应用。     

健择治疗非小细胞肺癌的护理

为探讨健择治疗晚期非小细胞肺癌的护理要点,笔通过对30例晚期非小细胞肺癌50次使用健择治疗的观察,提出护理重点在于掌握健择的配制,储存要求,调节滴注速度,加强对症护理,是防治不良反应的关键。     

复方苦参注射液对晚期非小细胞肺癌患者生活质量的影响

目的 探讨复方苦参注射液对晚期非小细胞肺癌(NSCLC)患者生活质量的影响.方法 78例晚期NSCLC患者随机分为复方苦参注射液观察组和对照组,两组同时进行紫杉醇+顺铂(TP)方案化疗,每21天为1周期,共化疗4个周期,观察组化疗同时静脉滴注复方苦参注射液,对照组化疗不加用该药.结果 观察组治疗4个周期后整体生活质量评分和5种功能状态(躯体、角色、情绪、认知、社会)的评分比治疗前和对照组显著增加(P＜0.01).观察组全身症状(乏力、疼痛)及肺癌相关症状(咳嗽、咯血、气短)的评分均较治疗前和对照组明显降低(P＜0.05).结论 复方苦参注射液可改善晚期NSCLC患者生活质量,降低化疗药物的不良反应.     

靶向治疗联合同步放化疗治疗晚期非小细胞肺癌患者的可行性

目的 探讨靶向治疗联合同步放化疗治疗晚期非小细胞肺癌患者的可行性.方法 选取我院收治的162例非小细胞肺癌患者作为研究对象,按治疗方式将其分为观察组(靶向治疗+同步放化疗)和对照组(同步放化疗),各81例.比较两组疾病控制情况、肿瘤标记物、KPS评分及生存情况.结果 观察组疾病控制率和疾病缓解率均高于对照组(P<0.0...     

Long-term use of combined conventional medicine and Chinese herbal medicine decreases the mortality risk of patients with lung cancer

BackgroundWe explored the effect of Chinese herbal medicine (CHM) on the long-term survival of lung cancer patients and hazard ratio (HR) and to analyse CHM herbs and formulas for lung cancer treatment.MethodsWe conducted a retrospective cohort study on diagnosed lung cancer patients in 2003–2016 from Taipei and Dalin Tzu Chi General Hospital Cancer Registry Database and from outpatient database from Chinese Medicine and Conventional Medicine Department. We categorised the patients into CHM user and CHM nonuser groups according to the CHM consumption time. After passing the proportional hazard assumption, we used the Cox PH model to calculate the groups’ survival hazard ratio (HR) and examine the statistical difference and effect of CHM on lung cancer survival.ResultsWe classified 2557 lung cancer patients into 1643 CHM nonusers and 228 CHM users. The CHM users had lower mortality than the CHM nonusers. With the multivariable Cox model, we observed that the CHM use was associated with 35% lower risk of mortality (adjusted HR: 0.65; 95% confidence interval: 0.51-0.76). Continuous CHM use of >180 days may further lessen the mortality risk by 64%. Finally, eight herbs and two formulas could significantly lower the mortality. After pairing the eight herbs for analysis, seven combinations could reduce the mortality better than only using one herb.ConclusionCHM users had significantly lower mortality than CHM nonusers. The longer the CHM use, the more the mortality HR declined. Glehnia littoralisF. Schmidt ex Miq., Polyporus umbellatus(Pers.) Fries and Trichosanthes kirilowii Maxim. possess a highly substantial anticancer activity compared with other herbs.     

改进的紫杉醇联合顺铂方案治疗晚期非小细胞肺癌的临床观察

目的 为比较紫杉醇联合顺铂改进的3周方案与传统3周方案治疗晚期NSCLC的疗效、毒副反应及1年生存率。方法75例经组织学或细胞学确诊的Ⅲb或Ⅳ期NSCLC患者,随机分为两组,分别接受改进方案（A组）和传统3周方案（B组）化疗。2周期后评价疗效与毒副反应,并随访1年生存率。结果A组无CR,A组总有效率为47．9％（18／37）;B组CR1例,总有效率为52．6％（20／38）。总有效率两组差异无显著性（P〉0．05）,两组1年生存率分别为38．2％和35．6％。两组差异无显著性（P〉0．05）。主要毒副反应为恶心、呕吐、骨髓抑制、脱发、周围神经毒性、肝功能受损、心脏毒性等。A、B组差异无显著性（P〉0．05）。关节肌肉疼痛A组32．4％;B组84．2％,两组差异有显著性（P〈0．05）。结论紫杉醇联合顺铂改进的3周方案治疗NSCLC与传统3周方案相比,疗效相似,但血液学毒性明显下降,耐受性好。     

The advanced lung cancer inflammation index predicts outcomes of patients with non-small cell lung cancer following video-assisted thoracic surgery

ObjectiveThe advanced lung cancer inflammation index (ALI) predicts overall survival (OS) in patients with advanced lung cancer. However, few studies have tested ALI’s prognostic effect in patients with non-small cell lung cancer (NSCLC) following video-assisted thoracic surgery (VATS), especially patients at stage III. This study investigated the relationship between ALI and outcomes of patients with NSCLC following VATS.MethodsWe retrospectively examined 339 patients with NSCLC who underwent VATS at Hebei General Hospital, China. Preoperative clinical and laboratory parameters were collected and analyzed. Optimal cutoff values of potential prognostic factors, including ALI, were determined. Kaplan–Meier and Cox regression analyses were used to determine each factor’s prognostic value.ResultsThe median OS was 31 months. The optimal cutoff value for ALI was 41.20. Patients with high ALI (≥41.20) displayed increased OS (33.87 vs. 30.24 months), higher survival rates, and milder clinical characteristics. Univariate and multivariate analyses showed a significant correlation between ALI and the prognosis of patients with NSCLC, including those at stage IIIA, who underwent VATS.ConclusionsLow ALI correlated with poor outcomes in patients with NSCLC following VATS. Preoperative ALI might be a potential prognostic biomarker for patients with NSCLC following VATS, including patients at stage IIIA.     

局部晚期非小细胞肺癌患者心脏受照射剂量与预后的关系

目的探讨心脏放射剂量与局部晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者预后的关系。方法回顾性分析2015年8月至2018年9月于河北省唐山市人民医院接受放射治疗的180例局部晚期NSCLC患者的临床数据和心脏剂量参数,采用K-M分析心脏剂量参数与总生存率的关系,通过多因素COX回归识别NSCLC患者预后的相关因子。结果NSCLC患者的中位生存时间为33.4个月。单因素分析提示计划靶区剂量≥56 Gy(HR1.54,95%CI1.28~2.86,P=0.011)、高血压(HR1.42,95%CI1.34~1.89,P=0.012)、平均心脏剂量≥13.9 Gy(HR1.12,95%CI1.05~2.61,P=0.031)、V5≥70%(HR1.08,95%CI1.01~2.16,P=0.044)、V30≥40%(HR1.16,95%CI1.04~3.01,P=0.041)、V50≥20%(HR1.23,95%CI1.11~2.81,P<0.001)和V60≥5%(HR1.03,95%CI1.00~1.89,P=0.037)是NSCLC患者预后的相关因素。经过多因素调整之后,化疗是NSCLC患者预后的有利因素(HR0.711,95%CI0.35~0.89,P=0.005);患有高血压是预后不良的相关因素(HR1.641,95%CI1.56~1.86,P=0.034);心脏剂量中的V50≥20%(HR1.161,95%CI1.13~3.82,P=0.002)是NSCLC患者预后不良的相关因素。结论心脏剂量中V50是晚期NSCLC患者预后的独立预测因子,心脏照射剂量的增加,可以增加潜在的死亡风险,临床实践中可以通过减少心脏放射剂量来改善患者预后。     

厄洛替尼治疗晚期非小细胞肺癌的临床研究

目的观察厄洛替尼治疗晚期非小细胞肺癌的疗效和毒副作用。方法38例经病理组织学检查确诊的晚期非小细胞肺癌患者，给予厄洛替尼150mg做，1次／d。结果38例患者均可以评价疗效，获CR1例（2．6％），PR11例（28．9％），SD19例（50．0％），PD7例（18．5％）。有效率（CR＋PR）为31．6％，疾病控制率（CR＋PR＋SD）为81．6％。腺癌的有效率优于鳞癌（P〈0．05），ECOG体力状况评分0～1分较2～3分的有效率高（P〈0．05）。中位疾病进展时间（1vrP）304d（95％CI：109-498d）；中位生存时间333d（95％CI：212--453d）。女性、腺癌、ECOG评分0～1分的TTP分别优于男性、鳞癌、ECOG评分2～3分者。腺癌、ECOG评分0～1分的中位生存时间分别优于鳞癌、ECOG评分2～3分者。经Cox风险比例模型分析，体力状况评分是服用厄洛替尼后TTP（HR：0．037，95％CI：0．010-0．147）和中位生存时间（HR：0．014。95％CI：0．002-0．125）独立的预测因素。最常见的毒副反应是皮疹和腹泻，对症处理后缓解。结论厄洛替尼治疗晚期非小细胞肺癌有一定的疗效．安全性高，在国人中女性、腺癌、体力状况好的患者将有可能更多获益。     

晚期非小细胞肺癌放化疗疗效观察

目的探讨同步放化疗与序贯化放疗治疗晚期非小细胞肺癌临床疗效及毒副反应。方法60例经病理或细胞学证实为非小细胞肺癌患者,鳞癌31例,腺癌23例,大细胞癌2例,未定型癌4例。经CT或MRI可测值病灶分期Ⅲa15例,Ⅲb30例,Ⅳ15例;年龄在21—86岁;Kamofsky评分／〉70;被随机分为A、B两组。A组30例为：序贯方法,即化疗＋放疗＋化疗;B组30例为：同步化放疗（周一-五放疗,周六化疗）＋化疗。结果近期疗效：PR＋CR：B组明显好于A组,差异有显著性。毒副作用：胃肠反应B组高于A组,骨髓抑制A组高于B组,差异有统计学意义。结论晚期非小细胞肺癌同步化放疗近期疗效明显优于序贯化放疗,而毒副作用没明显增加,更远期疗效尚待进一步观察。     

厄洛替尼治疗晚期非小细胞肺癌的临床研究

目的观察厄洛替尼治疗晚期非小细胞肺癌的疗效和毒副作用。方法38例经病理组织学检查确诊的晚期非小细胞肺癌患者,给予厄洛替尼150 mg/次,1次/d。结果38例患者均可以评价疗效,获CR 1例(2.6%),PR 11例(28.9%),SD 19例(50.0%),PD 7例(18.5%)。有效率(CR+PR)为31.6%,疾病控制率(CR+PR+SD)为81.6%。腺癌的有效率优于鳞癌(P<0.05),ECOG体力状况评分0~1分较2~3分的有效率高(P<0.05)。中位疾病进展时间(TTP)304 d(95%CI:109~498 d);中位生存时间333 d(95%CI:212~453 d)。女性、腺癌、ECOG评分0~1分的TTP分别优于男性、鳞癌、ECOG评分2~3分者。腺癌、ECOG评分0~1分的中位生存时间分别优于鳞癌、ECOG评分2~3分者。经Cox风险比例模型分析,体力状况评分是服用厄洛替尼后TTP(HR:0.037,95%CI:0.010~0.147)和中位生存时间(HR:0.014,95%CI:0.002~0.125)独立的预测因素。最常见的毒副反应是皮疹和腹泻,对症处理后缓解。结论厄洛替尼治疗晚期非小细胞肺癌有一定的疗效,安全性高,在国人中女性、腺癌、体力状况好的患者将有可能更多获益。     

晚期非小细胞肺癌综合治疗的前瞻性研究

目的探讨提高Ⅲ期非小细胞肺癌治疗效果的方法。方法85例Ⅲ期非小细胞肺癌患者随机分为3组,并进行不同顺序的治疗,A组(化疗+手术+放疗)28例,放疗后配合辅助化疗;B组(手术+化疗+放疗)28例;C组(手术+放疗+化疗)29例。比较各组3年生存率、局部区域复发率和远处转移率的差异性。结果A、B、C3组3年生存率分别为75.00%,53.57%,44.83%,其中A组与C组比较差异有显著性意义(P<0.05);3组局部区域复发率分别为7.14%,32.14%,17.24%,其中A组与B组比较差异有显著性意义(P<0.05);各组远处转移率分别为7.14%,10.71%,37.93%,其中A组与C组及B组与C组比较,差异均有显著性意义(P<0.05)。结论术前化疗再手术,配合术后放疗及辅助化疗,可提高治疗Ⅲ期非小细胞肺癌的疗效。