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[目的]探讨紫杉醇联合卡铂每周方案新辅助化疗治疗非小细胞肺癌的疗效和不良反应。[方法]54例非小细胞肺癌入组,按随机原则分组,试验组29例术前新辅助化疗,对照组25例直接手术。术前化疗,紫杉醇80mg/m2每周给予,共9次,卡铂AUC6每3周给予,共3次,化疗结束后2～6周手术,行肺叶切除及纵隔淋巴结清扫。化疗前后影像学检查测量肿块大小,术后行病理检查。[结果]试验组29例患者均完成新辅助化疗,总有效率55.2%(16/29)。临床完全缓解4例,其中2例达病理完全缓解,部分缓解12例,稳定13例,无疾病进展。不良反应主要包括3～4度中性粒细胞减少11例(37.9%),3度恶心1例(3.4%)。手术切除率为89.7%(26/29),手术并发症主要有肺部感染10.3%(3/29)、心律失常6.9%(2/29)、乳糜胸3.4%(1/29)、支气管残端瘘3.4%(1/29)等。中位随访42个月,3年总生存率为41.4%,明显优于对照组(24.0%)。[结论]紫杉醇联合卡铂每周方案具有较好的耐受性,不增加术后并发症及死亡率,具有较高的有效率。
[Objective] To investigate the efficacy and adverse reactions of paclitaxel combined with carboplatin weekly neoadjuvant chemotherapy for non-small cell lung cancer. [Method] Fifty-four patients with non-small cell lung cancer were enrolled in this study. According to randomized principle, 29 cases were treated with neoadjuvant chemotherapy in the experimental group and 25 cases in the control group. Preoperative chemotherapy, paclitaxel 80mg / m2 weekly, a total of 9 times, carboplatin AUC6 given every 3 weeks, a total of 3 times 2 to 6 weeks after the end of chemotherapy surgery, lobectomy and mediastinal lymph node dissection. Radiographic examination before and after chemotherapy to measure the size of the tumor, postoperative pathological examination. [Results] Twenty-nine patients in the experimental group received neoadjuvant chemotherapy, with a total effective rate of 55.2% (16/29). Four cases were completely relieved of clinical symptoms, of which two cases achieved complete remission, partial remission in 12 cases and stable in 13 cases without progression of disease. Adverse reactions include 3 to 4 degrees of neutropenia in 11 cases (37.9%), 3 cases of nausea in 1 case (3.4%). The surgical resection rate was 89.7% (26/29). The main complications were pulmonary infection 10.3% (3/29), arrhythmia 6.9% (2/29), chylothorax 3.4% (1/29), bronchial remnant Fistula 3.4% (1/29) and so on. At a median follow-up of 42 months, the 3-year overall survival was 41.4%, significantly better than the control group (24.0%). [Conclusion] Paclitaxel combined carboplatin weekly program has better tolerability, does not increase postoperative complications and mortality, with high efficiency.