论文部分内容阅读
目的探讨应用三磷酸腺苷生物荧光肿瘤化疗药敏检测(ATP-TCA)法指导非小细胞肺癌(NSCLC)个体化新辅助化疗的临床疗效。方法79例Ⅱ~Ⅲ期NSCLC患者,分为试验组40例,行ATP-TCA体外药敏检测,根据检测结果,选择敏感化疗方案行个体化新辅助化疗,体外无效者不行新辅助化疗;对照组39例选择常规第三代含(顺)铂两药联合化疗方案行新辅助化疗。结果试验组标本可评估率为92.5%,体外无效13.5%;四种化疗方案的体外有效率依次为吉西他滨+顺铂81.1%,多西他赛+顺铂(DP)78.4%,长春瑞滨+顺铂(NP)62.2%及柴杉醇+顺铂(TP)59.5%,各组比较差异无统计学意义。试验组临床有效率78.1%,手术完全切除率93.8%,对照组分别为64.1%和82.9%,差异无统计学意义。病理学疗效评价,试验组有效率78.1%,对照组54.3%,差异有统计学意义,与临床疗效评价不完全一致。结论根据ATP-TCA药敏检测结果指导NSCLC患者个体化新辅助化疗,结合病理组织学分级评价辅助化疗效果,有可能提高化疗疗效,减少无效化疗。
Objective To investigate the clinical efficacy of neoadjuvant chemotherapy for non-small cell lung cancer (NSCLC) guided by adenosine triphosphate biofluorescence chemosensitivity assay (ATP-TCA). Methods A total of 79 patients with stage Ⅱ-Ⅲ NSCLC were divided into experimental group (n = 40) and ATP-TCA in vitro. According to the results of the test, individualized neoadjuvant chemotherapy was selected according to the test results. Neoadjuvant chemotherapy Group 39 patients selected routine third-generation (cis) platinum two-drug combination chemotherapy regimen neoadjuvant chemotherapy. Results The evaluable rate of the experimental group was 92.5% and 13.5% in vitro. The in vitro efficacies of the four chemotherapy regimens were gemcitabine + cisplatin 81.1%, docetaxel + cisplatin (DP) 78.4%, vinorelbine + 62.2% of cisplatin (NP) and 59.5% of paclitaxel + cisplatin (TP). There was no significant difference between the groups. The clinical effective rate was 78.1% in the trial group, the complete resection rate was 93.8% in the experimental group and 64.1% and 82.9% in the control group, respectively, with no significant difference. Pathological efficacy evaluation, the experimental group was 78.1%, 54.3% in the control group, the difference was statistically significant, and clinical efficacy evaluation is not exactly the same. Conclusion According to the results of ATP-TCA susceptibility testing, we can guide the individual neoadjuvant chemotherapy in patients with NSCLC and evaluate the effect of adjuvant chemotherapy in combination with histopathological grade, which may increase the curative effect of chemotherapy and reduce the ineffective chemotherapy.