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目的:探讨同期放化疗后行全肺切除的Ⅲ期非小细胞肺癌患者的临床效果。方法:回顾性分析1998年5月至2008年6月我院同期放化疗后行全肺切除的37例Ⅲ期非小细胞肺癌患者的临床资料。37例患者在术前接受了同期放化疗后再行全肺切除术,其中17例行右全肺切除(包括2例肺上沟瘤)。所有患者术前均接受同期放化疗,放疗平均总剂量60.1 Gy。结果:所有患者均接受了全肺切除以达到根治切除(R0)的目的,16例(43.2%)患者达到了病理完全缓解。无手术死亡,术后平均住院天数9.1天。术后90天死亡率为2.7%(n=1)。术后共有13例(35.1%)患者出现多处转移。包括脑转移7例,骨转移5例,肝转移2例,肾上腺转移2例,肺转移2例,颈部淋巴结转移1例和小肠转移1例。5年生存率为32%。结论:同期放化疗后行全肺切除术在临床上值得进一步研究。
Objective: To investigate the clinical effect of total pneumonectomy stage Ⅲ non-small cell lung cancer patients after concurrent chemoradiotherapy. Methods: The clinical data of 37 patients with stage Ⅲ non-small cell lung cancer who underwent pneumonectomy after radiotherapy and chemotherapy in our hospital from May 1998 to June 2008 were retrospectively analyzed. Thirty-seven patients underwent pneumonectomy after concurrent chemoradiation prior to surgery. Seventeen patients underwent right pneumonectomy (including 2 pulmonary supraspinal tumors). All patients underwent concurrent chemoradiotherapy before surgery. The average total dose of radiotherapy was 60.1 Gy. Results: All patients underwent pneumonectomy for radical resection (R0), and 16 patients (43.2%) achieved complete remission. No operative death, the average postoperative hospital stay of 9.1 days. Mortality after 90 days was 2.7% (n = 1). Thirteen patients (35.1%) had multiple metastases after operation. Including 7 cases of brain metastases, 5 cases of bone metastases, 2 cases of liver metastases, 2 cases of adrenal metastases, 2 cases of lung metastases, 1 case of cervical lymph node metastasis and 1 case of intestinal metastasis. 5-year survival rate was 32%. Conclusions: Concurrent pneumonectomy after chemoradiotherapy is worth further study.