Preoperative chemotherapy increases cytokine production after lung cancer surgery

被引:19
作者
Endo, S [1 ]
Sato, Y [1 ]
Hasegawa, T [1 ]
Tetsuka, K [1 ]
Otani, S [1 ]
Saito, N [1 ]
Tezuka, Y [1 ]
Sohara, Y [1 ]
机构
[1] Jichi Med Sch, Dept Surg, Div Gen Thorac Surg, Kawachi, Tochigi 3290498, Japan
关键词
lung cancer; pulmonary resection; preoperative chemotherapy; surgical stress; postsurgical morbidity; inflammatory cytokine; interleukin-6;
D O I
10.1016/j.ejcts.2004.07.015
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Many phase II trials have shown that preoperative chemotherapy for lung cancer is feasible but associated with postoperative morbidity and mortality. However, little is known about the effect of preoperative chemotherapy on surgical stress and postoperative complications associated with surgical intervention. We evaluated the effect of preoperative chemotherapy on perioperative inflammatory cytokine production as a surgical stress marker. Methods: The study group comprised 38 patients undergoing anatomical lung resection and mediastinal nodal dissection for clinical stage IB/II non-small cell lung cancer during the period October 2001-December 2003. Nineteen patients received a single cycle of cisplatin (80 mg/m(2)) and docetaxel (60 mg/m(2)) chemotherapy prior to surgery (neoadjuvant group), and 19 patients underwent surgery without any previous chemotherapy (control group). White blood cell and neutrophil counts and serum concentrations of C-reactive protein (CRP), interieukin-6 (IL-6), and granulocyte colony-stimulating factor (GCSF) were determined before surgery and on postoperative days 1 and 3. Postoperative complications were reviewed. Differences were assessed by repeated analysis of variance. Results: Serum concentrations of IL-6 and GCSF rose significantly on postoperative days 1 and 3 in the neoadjuvant group in comparison to concentrations in the control group, but white blood cell count, neutrophil count, and CRP did not differ between the groups. No major complication occurred in either group. Conclusions: A single cycle of cisplatin and docetaxel chemotherapy followed by surgery can exacerbate overproduction of inflammatory cytokines during the perioperative period in lung cancer patients. (C) 2004 Elsevier B.V. All rights reserved.
引用
收藏
页码:787 / 791
页数:5
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