Yokomise Hiroyasu, Gotoh Masashi, Okamoto Taku, Yamamoto Yasumichi, Ishikawa Shinya, Liu Dage, Oka Shiro, Huang Cheng-Long
2nd Department of Surgery, Faculty of Medicine, Kagawa University, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
Eur J Cardiothorac Surg. 2007 May;31(5):788-90. doi: 10.1016/j.ejcts.2007.01.062. Epub 2007 Feb 27.
The optimal surgical treatment for non-small cell lung cancer (NSCLC) with vertebral body invasion remains both controversial and challenging. We reviewed our experiences of NSCLC with vertebral body invasion, in which we have performed induction chemoradiotherapy followed by lung resection with en bloc partial vertebrectomy.
Six NSCLC patients with vertebral invasion underwent an operation following chemoradiotherapy from January 2001 to July 2006. Vertebral invasion was evaluated by the chest CT and MRI findings. Either carboplatin-paclitaxel (n=3) or carboplatin-docetaxel (n=3) was used. Two cycles of chemotherapy were performed with concurrent radiation (50 Gy) treatment.
In all of the six cases, a complete resection with en bloc partial vertebrectomy was performed with no operative mortality. The histological complete response rate and major response rate were 16.7% (1/6) and 83.3% (5/6), respectively. The 5-year overall survival rate was 67.7%. In addition, no local failure was observed after surgery.
Surgery after chemoradiotherapy (carboplatin/paclitaxel or docetaxel and 50 Gy radiation) for NSCLC with vertebral invasion could thus be performed with acceptable morbidity.
对于伴有椎体侵犯的非小细胞肺癌（NSCLC），最佳手术治疗方案仍存在争议且颇具挑战性。我们回顾了我们治疗伴有椎体侵犯的NSCLC的经验，在这些病例中，我们先进行了诱导放化疗，随后行肺切除并整块部分椎体切除术。
2001年1月至2006年7月，6例伴有椎体侵犯的NSCLC患者在放化疗后接受了手术。通过胸部CT和MRI检查结果评估椎体侵犯情况。采用了卡铂-紫杉醇（n = 3）或卡铂-多西他赛（n = 3）方案。进行了两个周期的化疗并同时进行放疗（50 Gy）。
所有6例患者均成功进行了整块部分椎体切除术，无手术死亡病例。组织学完全缓解率和主要缓解率分别为16.7%（1/6）和83.3%（5/6）。5年总生存率为67.7%。此外，术后未观察到局部复发。
对于伴有椎体侵犯的NSCLC，采用卡铂/紫杉醇或多西他赛联合50 Gy放疗的放化疗后进行手术，其发病率是可以接受的。
