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目的探讨综合治疗对Ⅰ(Ⅰa+Ⅰb)期非小细胞肺癌(NSCLC)长期生存的影响。方法手术切除Ⅰa期和Ⅰb期NSCLC 983例,比较综合治疗与单纯手术的治疗效果。结果全组5年生存率:Ⅰa期综合治疗组和单纯手术组分别为80.2%和79.3%;Ⅰb期分别为61.6%和64.5%。不同病理类型5年生存率:鳞癌:Ⅰa期单纯手术79.0%,手术+化疗84.2%,手术+放疗57.1%;Ⅰb期单纯手术67.0%,手术+化疗+放疗65.6%,手术+化疗65.2%,手术+放疗47.9%。腺癌:Ⅰa期单纯手术80.0%,手术+化疗85.7%;Ⅰb期单纯手术65.2%,手术+化疗+放疗16.7%,手术+化疗72.4%。腺鳞癌:Ⅰb期单纯手术39.0%;Ⅰb期手术+化疗59.6%。但上述各组5年生存率之间均未见统计学差异。结论手术+化疗治疗Ⅰa期鳞癌、Ⅰa和Ⅰb期腺癌以及Ⅰb期腺鳞癌效果比单纯手术好。因此,手术+化疗应成为该类病例的标准治疗模式。
Objective To investigate the effect of comprehensive treatment on the long-term survival of Ⅰa + Ⅰb non-small cell lung cancer (NSCLC). Methods 983 cases of stage Ⅰa and Ⅰb NSCLC were surgically resected. The curative effect of comprehensive treatment and simple operation were compared. Results The 5-year overall survival rate was 80.2% and 79.3% respectively in stage Ⅰa and 61.6% and 64.5% in stage Ⅰb, respectively. The 5-year survival rates of different pathological types were as follows: squamous cell carcinoma: 79.0% of simple surgery in stage Ⅰa, 84.2% of surgery plus radiotherapy and 57.1% of surgery plus radiotherapy; 67% of simple surgery in stage Ⅰb, 65.6% of surgery plus chemotherapy and 65.2% , Surgery + radiotherapy 47.9%. Adenocarcinoma: stage Ⅰ a simple surgery 80.0%, 85.7% of surgery + chemotherapy; Ⅰ b simple surgery 65.2%, surgery + chemotherapy + radiotherapy 16.7%, surgery + chemotherapy 72.4%. Adenosquamous carcinoma: stage Ⅰ b 39.0% of simple surgery; Ⅰ b of surgery + chemotherapy 59.6%. However, there was no statistical difference between the 5-year survival rates of the above groups. Conclusions Surgical plus chemotherapy is superior to simple surgery in the treatment of stage Ⅰa squamous cell carcinoma, stage Ⅰa and stage Ⅰb adenocarcinoma and stage Ⅰb adenosquamous carcinoma. Therefore, surgery + chemotherapy should become the standard treatment of such cases.