ⅢA-N2期非小细胞肺癌术前新辅助放化疗临床分析

摘要

Objective:To explore the curative effect and prognosis of the neoadjuvant chemoradiation com-bined with surgery in the treatment of patients with ⅢA-N2 non-small-cell lung cancer (NSCLC).Methods:128 cases of patients with ⅢA-N2 non-small-cell lung cancer from November 2008 to 2015 March in Puyang Oilfield General Hospital were selected and randomly divided into experimental group (64 cases)and control group (64 cases).Both experimental group and control group patients were treated with preoperative three cycles of paclitaxel + cisplatin chemotherapy,every 3 weeks for a cycle.After 3 cycles of chemotherapy,the experimental group patients were sequentially treated with three-dimensional conformal radiotherapy.After operation all patients were treated with 3 cycles of chemotherapy like the treatment plan before operation. Then compared the treatment effect and analyzed the nprognosis factors and adverse reactions of preoperative neoadjuvant chemotherapy in two groups.Results:After chemoradiation,the disease effective rate of the ex-perimental group was 79.7%,and the disease control rates was 96.9%;The median progression-free survival time was 1 1.8 months,the median survival time was 26.3 months,and 1 year survival rate is 93.8%.After chemotherapy,the effective rate of the control group was59.4%,and the disease control rates was 85.9%;The median progression-free survival time was 8.2 months,the median survival time was 1 9.8 months,and 1 year survival rate was 81.3%.The difference of efficiency,disease control rate and survival rate between the two groups were statistically significant (P <0.05).The main adverse reactions of two groups had no obvious statistical significance (P >0.05),which can be recovered after treatment.Conclusion:Preoperative neoadju-vant chemoradiation was able to improve prognosis,and no increase adverse reactions for patients,which can be used as one of the best treatment plans with ⅢA-N2 non-small-cell lung cancer.%目的：：探讨新辅助放化疗联合手术治疗ⅢA-N2期非小细胞肺癌的疗效及预后。方法：选取2008年11月~2015年3月濮阳市油田总医院收治的128例ⅢA-N2期非小细胞肺癌患者,随机划分为实验组(64例)和对照组(64例),均行术前3个周期的紫杉醇+顺铂方案化疗,每3周为1个周期；实验组：3周期化疗后行三维适形放疗,对照组仅行术前化疗；术后所有患者均再行原方案化疗3周期。对比分析经两组患者术前新辅助放化疗的疗效、不良反应及预后因素。结果：实验组放化疗后有效率为79.7%,疾病控制率为96.9%。中位无进展生存时间11.8个月,中位生存期26.3个月,1年生存率为93.8%；对照组化疗后有效率为59.4%,疾病控制率为85.9%。中位无进展生存时间8.2个月,中位生存期19.8个月,1年生存率为81.3%。两组间有效率、疾病控制率及生存率差异均有统计学意义(P <0.05),不良反应无明显统计学意义(P >0.05),对症支持治疗后均可恢复。结论：术前新辅助放化疗有利于提高预后,并且不增加患者不良反应。安全性好。可作为ⅢA-N2期非小细胞肺癌最佳治疗方案之一。