摘要
背景与目的:目前,关于非小细胞肺癌(non-small cell lung cancer,NSCLC)患者左全肺切除术后是否需要化疗仍然存在争议。本研究探讨NSCLC患者左全肺切除术后是否需要化疗,以及化疗对其中的哪类患者有益。方法:以天津医科大学附属肿瘤医院肺部肿瘤科1997年1月至2002年1月可供分析的、左全肺切除术后化疗的51例NSCLC患者为化疗组,给予TP/NP方案化疗。同时随机抽取单独行左全肺切除术的102例NSCLC患者为对照组。应用SPSS13.0统计学软件包进行统计,对比分析两组患者的生存情况。结果:研究组NSCLC患者左全肺切除术并化疗后1、3、5年生存率分别为88.2%、54.9%、36.1%,对照组分别为76.5%、37.3%、23.9%。两组比较差异无统计学意义(P>0.05)。ⅢA期或N2期NSCLC患者左全肺切除术后化疗组1、3、5年生存率均明显高于单独手术组,差异有统计学意义(P<0.05)。术前第一秒用力肺活量(forced expiratory volume at the first second,FEV1)>2L的左全肺切除术后化疗组患者的1、3、5年生存率分别为89.2%、64.9%、46.2%,显著高于对照组的78.8%、42.4%、25.0%,差异有统计学意义(P<0.05)。化疗组年龄大于或小于等于65岁患者的生存率与对照组相比差异均无统计学意义(P>0.05)。结论:对于术前FEV1>2L的NSCLC患者左全肺切除术后化疗有益于提高生存率,尤其是其中的N2及ⅢA期患者。年龄不是NSCLC患者左全肺切除术后是否化疗的参考指标,年龄大者,如术前肺功能好仍需化疗。
BACKGROUND ＆ OBJECTIVE： Presently, whether non-small cell lung cancer （NSCLC） patients may benefit from adjuvant chemotherapy after left pneumonectomy is controversial. This study was to evaluate the efficacy of adjuvant chemotherapy after left pneumonectomy on NSCLC, and explore candidate patient selection for adjuvant chemotherapy. METHODS, Clinical data of 51 NSCLC patients received radical left pneumonectomy and adjuvant chemotherapy of TP/NP regimen and 102 patients received left pneumonectomy alone between Jan. 1997 and Jan. 2002 were compared. RESULTS. The 1-, 3-, and 5-year survival rates were 88.2%, 54.9%, and 36.1% in adjuvant chemotherapy group, and 76.5%, 37.3%, and 23.9% in control group （P〉0.05）. For the patients at stage N2 or Ⅲ A, the 1-, 3-, and 5-year survival rates were significantly higher in adjuvant chemotherapy group than in control group （P〈0.05）. For the patients with preoperative forced expiratory volume at the first second （FEVl） of 〉2 L, the 1-, 3-, and 5-year survival rates were significantly higher in adjuvant chemotherapy group than in control group （P〈0.05）. For the patients aged of 〉65 or ≤65, there was no significant difference in survival between the two groups （P〉0,05）. CONCLUSIONS, For the NSCLC patients at stage Ⅲ A, N2 or with preoperative FEVl of 〉2 L, adjuvant chemotherapy after left pneumonectomy may improve survival rate. For the patients with good pulmonary function, even aged patients, adjuvant chemotherapy is needed.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2007年第12期1365-1368,共4页
Chinese Journal of Cancer
关键词
肺肿瘤/外科手术
癌
非小细胞
辅助化疗
全肺切除术
疗效
Lung neoplasm/surgical operation
Carcinoma, non-small cell
Adjuvant chemotherapy
Pneumonectomy
Efficacy
