Spásová I, Petera J, Hytych V
Department of Pulmonary Medicine; University Hospital in Hradec Kralove, Hradec Kralove, 500 05 Czech Republic.
Neoplasma. 2002;49(3):189-96.
The study was undertaken to test whether marginally resectable or unresectable stage IIIa-IIIb non-small cell lung cancer (NSCLC) patients could reach complete resectability after induction chemotherapy. Fifty six patients were included into the study and treated either by vinorelbine 35 mg/m2 day 1 and cisplatin 75 mg/m2 day 1 (n=28) or by vinorelbine 30 mg/m2 day 1 and 8 and cisplatin 80 mg/m2 day 1 (n=28). Cycles were repeated every 21 days. At the completion of induction therapy patients assessed to be resectable underwent thoracotomy. Radiation therapy was applicated in nonresected cases. The minimal follow up was 24 months. 32% of patients with marginally resectable or unresectable stage IIIa-IIIb NSCLC could reach a complete resectability after induction chemotherapy. Survival of patients stage IIIa was comparable to stage IIIb. Responders and resected patients survived significantly longer comparing to the patients with stable disease and progression, respectively to the incompletely resected plus nonresected patients. Perioperative complications were rare and there were no treatment-related deaths in our study. The main surgery-related complication was late bronchopleural fistula.
本研究旨在测试边缘可切除或不可切除的Ⅲa-Ⅲb期非小细胞肺癌（NSCLC）患者在诱导化疗后是否能达到完全可切除状态。56例患者纳入本研究，分别接受长春瑞滨35mg/m²第1天和顺铂75mg/m²第1天治疗（n = 28）或长春瑞滨30mg/m²第1天和第8天和顺铂80mg/m²第1天治疗（n = 28）。每21天重复一个周期。诱导治疗结束后，评估为可切除的患者接受开胸手术。不可切除的病例接受放射治疗。最短随访时间为24个月。32%边缘可切除或不可切除的Ⅲa-Ⅲb期NSCLC患者在诱导化疗后可达到完全可切除状态。Ⅲa期患者的生存率与Ⅲb期相当。与病情稳定和进展的患者相比，缓解者和接受手术切除的患者分别存活时间显著更长，与不完全切除加未切除的患者相比也是如此。围手术期并发症罕见，本研究中无治疗相关死亡。主要的手术相关并发症是迟发性支气管胸膜瘘。
