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目的探讨术前GP方案新辅助化疗治疗Ⅲ期非小细胞肺癌的可行性和不良反应,同时评价其在病期下调率,提高手术切除率及患者生存率的作用。方法将62例Ⅲ期非小细胞肺癌患者采用信封抽签法随机分为新辅助化疗组和单纯手术组,新辅助化疗组术前GP方案化疗二周期,单纯手术组直接手术治疗。结果新辅助化疗组总有效率为80.0%(24/30),病期下调率为56.7% (17/30)。新辅助化疗组手术切除率为92.9%(26/28),单纯手术组为87.5%(28/32)。手术并发症和手术死亡率两组间比较差异无显著性(P>0.05)。新辅助化疗组术后1,2,3年生存率分别为89.3%(25/28)、78.6%(22/28)和64.3%(18/28),单纯手术组分别为71.9%(23/32)、53.1%(17/ 32)和40.6%(13/32)。新辅助化疗组术后生存率显著高于单纯手术组(P<0.01)。结论术前GP方案化疗安全、有效能降低Ⅲ期非小细胞肺癌的病期,提高手术切除率,改善患者术后长期生存率和生活质量。
Objective To investigate the feasibility and adverse reactions of preoperative chemotherapy regimen of neoadjuvant chemotherapy for stage Ⅲ non-small cell lung cancer (NSCLC), and to evaluate the effect of GP regimen down-regulation and improve the resection rate and survival rate. Methods Sixty - two patients with stage Ⅲ non - small cell lung cancer were randomly divided into neoadjuvant chemotherapy group and simple operation group by enveloping test. Neoadjuvant chemotherapy group received preoperative GP regimen two cycles and surgery alone group. Results The total effective rate of neoadjuvant chemotherapy group was 80.0% (24/30), and the down-regulation rate was 56.7% (17/30). Surgical resection rate was 92.9% (26/28) in neoadjuvant chemotherapy group and 87.5% (28/32) in simple surgery group. There was no significant difference between the two groups in the incidence of complications and operative mortality (P> 0.05). The 1, 2, 3-year survival rates of the neoadjuvant chemotherapy group were 89.3% (25/28), 78.6% (22/28) and 64.3% (18/28), respectively. The survival rates of the neoadjuvant chemotherapy group were 71.9% 32), 53.1% (17/32) and 40.6% (13/32). The survival rate of the neoadjuvant chemotherapy group was significantly higher than that of the simple operation group (P <0.01). Conclusions The preoperative chemotherapy of GP regimen is safe and effective, which can reduce the stage of stage Ⅲ non-small cell lung cancer, improve the resection rate, and improve the postoperative long-term survival and quality of life.