多中心多学科治疗模式下对局部晚期非小细胞肺癌患者的新辅助化疗疗效及预后影响的临床研究-东南大学学报医学版

多中心多学科治疗模式下对局部晚期非小细胞肺癌患者的新辅助化疗疗效及预后影响的临床研究

单位：1. 南充市中心医院胸心外科, 四川南充 637000;
2. 南充市中心医院肿瘤科, 四川南充 637000

分类号：R734.2

出版年·卷·期（页码）：2018·37·第四期（667-672）

摘要：

目的：探讨多中心多学科治疗（MDT）模式下对局部晚期非小细胞肺癌（NSCLC）患者的新辅助化疗疗效及预后影响。方法：选择本院2013年3月至2015年7月收治的110例局部晚期NSCLC患者，将其随机分为研究组与对照组，各55例。对照组采用单中心标准模式治疗，研究组采用多中心MDT模式治疗。比较两组患者的临床有效率、相关临床及预后指标的变化。结果：与对照组相比，研究组新辅助化疗后纵隔淋巴结缩小更加明显（P<0.05）。2周期新辅助化疗后，研究组的临床有效率（69.1%）显著高于对照组（41.8%），差异有统计学意义（P<0.05）。研究组平均住院费用及平均住院时间均少于对照组，术后VAS疼痛评分也显著低于对照组，差异均有统计学意义（P<0.05）。尽管在1年生存率方面，两组比较差异无统计学意义（P>0.05），但研究组生存率（65.5%）仍高于对照组（50.9%），同时研究组PFS明显高于对照组（P<0.05）。治疗前，两组血清预后相关指标比较均差异无统计学意义（P>0.05）；治疗后，两组血清预后相关指标浓度均降低，且研究组显著低于对照组（P<0.05）。治疗后研究组肺癌患者生存质量量表（FACT-L）评分显著优于对照组（P<0.05）。结论：在对中晚期NSCLC患者进行治疗时，多中心MDT模式较单中心标准模式在一定程度上可提高患者的临床疗效及生活质量，同时可改善预后，值得临床推广应用。

Objective:To explore the clinical study of neoadjuvant chemotherapy efficacy and prognosis in the application of multicenter multidisciplinary treatment for locally advanced non-small cell lung cancer (NSCLC) patients.Methods:The patients with NSCLC were randomly collected and divided into the study group (n=55) and the control group (n=55) from March 2013 to July 2015 in our hospital. The single center standard treatment model was used in the control group, and multicenter MDT model was applied in the study group. The clinical efficiency, clinical and prognosis correlation indexes were compared between the two groups using statistical analysis. Results:Compared to the control, the size of mediastinal lymph nodes decreased more significantly after chemical treatment in the study group(P<0.05). After two weeks treatment,the effective rate in the study group(69.1%)was significantly higher than that in the control group(41.8%)(P<0.05). Compared with the control group, the average hospital cost, the length of stay, the VAS scores were lower in the study group(P<0.05). Although there was no significant difference for the 1-year survival rate between the two groups (P>0.05), the survival rate of the study group (65.5%) was higher than that of the control group (50.9%),while PFS in the study was more than that of the control group (P<0.05). Additionally, there was no significant difference in serum prognosis between the two groups before treatment. However, after treatment,the serum prognostic markers of the two groups decreased,and the levels in the study group were lower than those of the control group (P<0.05). The FACT-L scores in the study group were also higher than that of the control group after treatment(P<0.05). Conclusion:The multicenter multidisciplinary team model is an effective measure for locally advanced NSCLC patients, which helps patients to improve the effective rate,the quality of life and the prognosis. Therefore, this model should be widely applied in clinical treatment.

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