非小细胞肺癌术后辅助化疗随机研究

目的评价非小细胞肺癌（ＮＳＣＬＣ）根治术后辅助化疗疗效。方法７０例Ⅰ～Ⅲ期ＮＳＣＬＣ患者在根治术后被随机分为两组。一组为辅助化疗组,于手术后３～４周开始接受辅助化疗：环磷酰胺３００ｍｇ／ｍ２;长春新碱１．４ｇ／ｍ２;阿霉素５０ｍｇ／ｍ２,第１天;顺铂２０ｍｇ／ｍ２,第１～５天;环己亚硝脲５０ｍｇ／ｍ２,第１天（ＣＯＡＰＣ方案）。每４～６周重复疗程,共４疗程。此后开始口服喃氟啶２００～３００ｍｇ,每天３次,连用１年或至肿瘤复发止。另一组为单纯手术组。结果辅助化疗组和手术组总的（Ⅰ～Ⅲ期）５年生存率分别为４８．６％和３１．４％,差异无显著性（Ｐ＞０．０５）;Ⅲ期病例的５年生存率分别为４４．０％和２０．８％,差异有显著性（Ｐ＜０．０２５）。Ⅰ～Ⅱ期病例分别为６０．０％和５４．５％（Ｐ＞０．７５）。结论ＮＳＣＬＣ根治术后辅助化疗,其５年生存率有一定提高,其中Ⅲ期病例的５年生存率,辅助化疗组优于单纯手术组。

Adjuvant chemotherapy following radical surgery for non-small cell lung cancer: a randomized study

OBJECTIVE: To evaluate the efficacy of adjuvant chemotherapy after radical surgery for non-small cell lung cancer (NSCLC). METHODS: Seventy patients with NSCLC(stage I-III) undergone radical surgery were randomized into two groups: 35 patients received adjuvant chemotherapy with cyclophosphamide (CTX) 300 mg/m2, vincristine(VCR) 1.4 mg/m2, adriamycin(ADM) 50 mg/m2, d1; cisplatin (PDD) 20 mg/m2, d1-5, for 4 cycles, and followed by oral ftorafur (FT-207) 600-900 mg/d for 1 year (adjuvant chemotherapy group). The other 35 patients received surgical treatment only (surgery group). RESULTS: The overall 5-year survival rate was 48.6% in the adjuvant chemotherapy group, and 31.4% in the surgery group, respectively. The difference between the two groups was not statistically significant (P > 0.05). The 5-year survival rate of patients in atage III was 44.0% and 20.8% (5/24) received surgery with and without adjuvant chemotherapy, respectively. The difference between the two groups was statistically significant (P < 0.025). The 5-year survival rate of patients in stage I-II in the two group was 60.0% and 54.5%, respectively (P > 0.75). CONCLUSION: Postoperative adjuvant chemotherapy in NSCLC improves survival but only in patients in stage III, it results in significantly higher 5-year susvival rate than surgery alone.