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. 2017 Feb 20;20(2):100-106.
doi: 10.3779/j.issn.1009-3419.2017.02.04.

[Efficacy and Potential Application of Neoadjuvant Chemotherapy in Patients with IIIa Stage Non-small Cell Lung Cancer]

[Article in Chinese]
Cuiping Tang  1 , Si Qin  1 , Wanchun Wu  1 , Yang Wu  2 , Tao Zhang  1
Affiliations

[Efficacy and Potential Application of Neoadjuvant Chemotherapy in Patients with IIIa Stage Non-small Cell Lung Cancer]

[Article in Chinese]
Cuiping Tang et al. Zhongguo Fei Ai Za Zhi. .

Abstract
in English, Chinese

Background: The therapeutic effect and side effect of neoadjuvant chemotherapy were still disputing issues when applied to resectable IIIa stage non-small cell lung cancer (NSCLC) patients. The retrospective analysis was aimed to investigate the short-term efficacy and postoperative complications in resectable IIIa NSCLC patients treated with neoadjuvant chemotherapy.

Methods: According to inclusion criteria and exclusion criteria, 370 patients with clinical diagnosis of IIIa NSCLC were selected from our hospital between January 2011 and October 2013 were retrospectively analyzed. According to treatment method, group A (preoperative neoadjuvant chemotherapy+surgery group) contained 97 cases, and 273 patients were included in group B (direct surgery without neoadjuvant treatment group). The clinical data, surgical approach, main postoperative complications and disease-free survival (DFS) among patients in two groups were recorded.

Results: The total down-staging in group A was 65.98% (64/97), the R0 resection in group A and group B were 96.91% (94/97) and 90.48% (247/273), respectively. The operation time, bleeding, postoperative hospitalization were no statistical difference (P>0.05), and the main postoperative complications of the patients in two groups were 76.29% (74/97) and 72.52% (198/273) (P>0.05). All patients followed-up for 2 months-36 months, the median follow-up time was 12.7 months, the total recurrence and metastasis rates were 63.92% (62/97) and 94.87% (259/273) (P<0.05) and the median DFS were 19.46 months and 11.34 months (P<0.001).

Conclusions: Neoadjuvant chemotherapy can benefit patients of IIIa stage NSCLC partly in down-staging T and N stage in tumor, enhance the R0 resection, but not significantly increased the postoperative complications of the patients, which can reduce the local recurrence and metastasis, enhance the DFS effectively.

背景与目的 新辅助化疗应用于可手术切除的IIIa期非小细胞肺癌（non-small cell lung cancer, NSCLC）患者的确切疗效及安全性尚存争议。本研究旨在探讨新辅助化疗对可手术切除IIIa期NSCLC患者的近期疗效，并分析其与术后并发症的相关性。方法 根据纳入及排除标准，回顾性分析2011年1月-2013年10月重庆医科大学附属第一医院收治的明确临床诊断为IIIa期NSCLC 370例患者完整资料，根据术前是否接受新辅助化疗分为两组，其中A组为新辅助化疗+手术组97例，B组为直接手术组273例，比较两组患者的临床资料，分析新辅助化疗后肿瘤降期率，并将两组患者的手术情况、术后并发症进行对比，统计两组患者3年无病生存期（disease-free survival, DFS）。 结果 A组患者新辅助化疗后肿瘤总降期率为65.98%（64/97）；两组患者R0切除率分别为96.91%（94/97）和90.48%（247/273），手术时间、术中出血量、术后平均住院日差异均无统计学意义（P>0.05）；术后并发症总发生率A组稍高于B组，分别为76.29%（74/97）和72.52%（198/273），差异无统计学意义（P>0.05）；所有患者术后随访2个月-36个月，中位随访时间12.7个月，两组患者术后总体复发转移率分别为63.92%（62/97）和94.87%（259/273），有统计学差异（P<0.05）；A、B两组患者中位DFS分别为19.46个月和11.34个月，差异有统计学意义（P<0.001）。结论 新辅助化疗可使IIIa期NSCLC患者受益，能有效降低肿瘤分期，提高肿瘤切除率，可降低术后局部复发率及远处转移率，提高患者的无进展生存期；且并不明显增加术后并发症的发生率。.

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Figures

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两组NSCLC患者的无病生存曲线 Disease-free survival curve of the NSCLC patients in two groups
See this image and copyright information in PMC

References

    1. Torre LA, Bray F, Siegel RL, et al. Global Cancer Statistics, 2012. CA Cancer J Clin. 2015;65(2):87–108. doi: 10.3322/caac.21262. - DOI - PubMed
    1. Zhi XY, Shi YK, Yu JM, et al. Chinese lung cancer treatment guildlines (2015 edition) Zhonghua Zhong Liu Za Zhi. 2015;37(1):67–78. - PubMed
    2. 支 修益, 石 远凯, 于 金明, et al. 中国原发性肺癌诊疗规范(2015年版) 中华肿瘤杂志. 2015;37(1):67–78. - PubMed
    1. Chen WQ, Zhang SW, Zou XN. Estimation and projection of lung cancer incidence and mortality in China. Zhongguo Fei Ai Za Zhi. 2010;13(5):488–493. - PMC - PubMed
    2. 陈 万青, 张 思维, 邹 小农. 中国肺癌发病死亡的估计和流行趋势研究. 中国肺癌杂志. 2010;13(5):488–493.
    1. Group NM. Preoperative chemotherapy for non-small-cell lung cancer: a systematic review and meta-analysis of individual participant data. Lancet. 2014;383(9928):1561–1571. doi: 10.1016/S0140-6736(13)62159-5. - DOI - PMC - PubMed
    1. Hegde P, Liberman M. Echo-endoscopic lymph node staging in lung cancer: an endoscopic alternative. Expert Rev Anticancer Ther. 2015;15(9):1063–1073. doi: 10.1586/14737140.2015.1067143. - DOI - PubMed