序贯性化疗、放疗和手术切除治疗肺尖癌28例分析

目的 探讨肺尖癌的综合治疗模式。方法 回顾分析我院1989年1月～1997年1月应用化疗(2个周期)、放疗(30～40Gy)加扩大性手术切除治疗肺尖癌28例。结果 化、放疗后CR 6例,PR 18例,MR 4例,总有效率为85.0％。全组出现并发症6例,肿块中心癌细胞变形和残存22例。纵隔淋巴结癌细胞阳性3例。全部达到根治性切除。术后5年生存率为42.8％(12/28)。结论 化疗可以杀灭部分癌细胞,消灭微小转移灶,对放疗起到增敏作用,放疗可以使局部病灶缩小,使患者的TNM分期提前。因此,序惯性化疗、放疗加扩大性手术切除应作为肺尖癌治疗的首选方案。

Concurrent chemotherapy,radiotherapy and surgical resection for treatment of 28 cases of apical lung cancer

Objective To explore the combined treatment regimen of the apical lung cancer.Methods From January 1989 to January 1997,28 patients with apical lung cancer in our hospital were treated with concurrent chemotherapy,radiotherapy and expanding surgical resection.Results Total response rate was 85% after chemotherapy and radiotherapy, including CR 6 cases, PR 18 cases and MR 4 cases. Six cases developed complications. No death occurred in all 28 patients during operation. Postoperative pathological examination revealed that cancer cell did not found in 6 cases,22 cases showed cancer cells deformed and remaining in the centre of cancer lump, 3 cases had the mediastinal lymph node metastasis. All 28 patients achieved the radical operation. The postoperative 5-year survival rate was 42.8 % (12/28). Conclusion The chemotherapy can reduce cancer cells, eliminate the occult micrometastasis and improve the efficacy of radiotherapy. The radiotherapy can reduce the local pathological change and advance the TNM stage of patients. Therefore, the use of concurrent chemotherapy, radiotherapy and expanding surgical resection is the treatment of first choice for apical lung cancer.