84例ⅢA-N期非小细胞肺癌术前新辅助临床治疗结果分析

被引：11

作者：

杨海堂

姚烽

赵洋

澹台冀瀓

赵珩

机构：

[1] 上海交通大学附属胸科医院胸外科

来源：

中国肿瘤临床 | 2015年 / 12期

关键词：

非小细胞肺癌; 纵隔淋巴结转移; 新辅助治疗; 降期; 手术;

D O I：

暂无

中图分类号：

R734.2 [肺肿瘤];

学科分类号：

100214 ;

摘要：

目的:探讨新辅助结合手术切除治疗ⅢA-N2期非小细胞肺癌的临床疗效。方法:收集2008年1月至2013年7月上海交通大学附属胸科医院收治的术前明确单侧纵隔淋巴结(且淋巴结短径≥1 cm)转移(ⅢA-N2期),经新辅助治疗后再手术的非小细胞肺癌(non-small cell lung cancer,NSCLC)91例患者。总结并分析经术前新辅助治疗的反应率以及患者的生存情况并分析影响预后的因素。结果:3年和5年总生存期(OS)分别为57.7%和34.2%;3年和5年无病生存期(DFS)分别为37.9%和30.5%。在OS和DFS方面,R0和R1组之间(P=0.118;P=0.369)、新辅助化疗和放化疗组之间(P=0.771;P=0.953)、临床反应和无反应组之间(P=0.865;P=0.862)以及不同组织病理类型组之间(P=0.685;P=0.208)比较差异均无统计学意义。肺叶切除及术后病理性淋巴结降期的患者分别优于相应地扩大性切除(P=0.023;P=0.024)和未降期(P=0.036;P=0.025)的患者。单因素分析显示肺叶切除和术后病理性淋巴结降期为有利的预测因子。多因素分析显示,病理淋巴结降期为术后DFS的有利预测因子;无吸烟史及肺叶切除为OS的有利预测因子。结论:术前新辅助治疗ⅢA-N2期NSCLC是可行的,能有效地使肿瘤大小及淋巴结降期,预后较为满意;预测预后方面,术后病理性降期要比临床反应更有意义;可行根治性肺叶切除及有病理性淋巴结降期的患者预后更好。

引用

页码：620 / 625

页数：6

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