术前新辅助化疗对局部晚期非小细胞肺癌患者近期疗效及远期生存率的影响探究

目的探讨新辅助化疗联合手术治疗局部晚期非小细胞肺癌患者的疗效及远期生存率。方法采用前瞻性研究方法，以随机数字表法将2007年1月至2008年1月沂南县人民医院收治的284例局部晚期非小细胞肺癌患者分为试验组和对照组，试验组给予术前新辅助化疗，化疗结束后进行手术治疗；对照组仅给予手术治疗。计算试验组新辅助化疗有效率及病期下调率，比较两组患者手术切除率，以及1、3、5年生存率及中位生存期。结果试验组临床治疗的总有效率和病期下调率分别为63．4％和38．7％；试验组手术切除率为92．3％，对照组为84．5％；试验组1、3、5年生存率及中位生存期分别为78．9％、55．6％、35．2％及（45．4±13．3）个月，对照组则为68．5％、38．0％、19．0％及（30．3±12．1）个月，试验组手术切除率，1、3、5年生存率，中位生存期均显著高于对照组（P〈0．05）。结论对于局部晚期非小细胞肺癌患者术前给予新辅助化疗能够显著提高手术切除率、远期生存率，值得临床推广应用。

The Influence of Preoperative Neoadjuvant Chemotherapy on the Short-term and Long-term Survival Rate of Locally Advanced Non-small Cell Lung Cancer

Objective To investigate efficacy and long-term survival rate of＇ locally advanced non-small cell lung cancer patients treated with neoadjuvant chemotherapy and surgical treatment. Methods Prospec- tive control study was adopted in 284 patients with locally advanced non-small cell lung cancer fi：om Jan. 2007 to Jan. 2008 of People＇s Hospital of Yinan ,the patients were randomly divided into trial group and con- trol group with random number table method. The trial group was given preoperative neoadjuvant chemothera- py and surgery, while the control group only received surgical treatment. Neoadjuvant chemotherapy efficiency rate and lowered stage rate of the trial group were computed after treatment. Resection, 1-year,3-year,5-year survival rate and median survival time of the two groups were compared. Results Neoadjuvant chemotherapy efficiency rate and lowered stage rate of the trial group were 63.4% and 38.7%, resection rate of the trim group was 92.3%, the control group was 84.5 %. 1-year, 3-year, 5-year survival rate and median survival time of the trial group were 78.9% ,55.6% ,35.2%, （45.4 _＋ 13.3 ） m,of the control group were 68.5%, 38.0%, 19.0 % , （ 30.3 ＋ 12.1 ） m. Resection rate, 1 -year, 3 -year, 5-year survival rate, median survival time of the trial group were significantly higher than those of the control group （ P 〈 0.05 ）. Conclusion Neoadju- vant chemotherapy for locally advanced non-small cell lung cancer patients before surgery can significantly increase the rate of surgical resection, as well as the long-term survival of patients, which is worthy of clinical application.