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Objective To evaluate the clinical efficacy of thoracoscopic surgery combined with chemorad-iotherapy in patients with N2 stage ⅢA non-small cell lung cancer (NSCLC). Methods 40 patients (study group) received thoracoscopic surgery and another 40 patients (control group) received traditional thoracotomy. Combination therapy with navelbine and cisplatin were postoperatively administered for four cycles and one cycle lasted for 3 weeks. 7 to 14 days after chemotherapy , sequential conformal radiotherapy were delivered. The one-year survival and two-year survival rates , duration of tatal treatment , and adverse reactions were compared between the two groups. Results In the study group, duration of total treatment time and time to postoperative chemotherapy were significantly shorter (χ2=9.45,P=0.002 andχ2=41.324, P=0.000), and the KPS score was significantly higher (χ2 = 15.118,P = 0.002). No significant differences were found between the two groups in bone marrow suppression,gastrointestinal reactions,and one- or two-year survival rate. Conclusions As compared with conventional surgery,post-thoracoscopic surgery sequential chemoradiotherapy for patients with N2 stage ⅢA NSCLC could achieve a better efficacy with less surgical trauma , shorter hospital stay , faster recovery , and shorter time to postoperative chemotherapy and total treatment duration;it is worth further researching and popularizing.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the therapeutic efficacy of two regimens of postoperative radiotherapy with concurrent chemotherapy using temozolomide (TMZ) and teniposide (VM-26) plus semustine (Me-CCNU) in adult patients with grade III-IV cerebral gliomas.</p><p><b>METHODS</b>Ninety-six adult postoperative patients with grade III-IV cerebral gliomas were randomized into two groups (n=48) to receive 60 Gy radiotherapy with concurrent TMZ treatment (TMZ-RT group) and radiotherapy with VM-26 plus Me-CCNU treatments (VM-RT group). The adverse effects of marrow depression, gastrointestinal toxicity and acute radiation-induced brain injury were observed. The immediate effect and survival outcome of the patients were compared between the two groups.</p><p><b>RESULTS</b>No adverse effects beyond grade III were observed in the two groups. TMZ-RT group showed a significantly lower incidence of grade I-II adverse effects than VM-RT group (P<0.05). The median survival time and 1-, 2-, and 3-year survival rates of the patients in TMZ-RT group were 28 months, 72.9%, 54.2% and 31.3%, respectively, showing significant differences from those in VM-RT group (16 months, 62.5%, 33.3% and 16.7%, respectively, P<0.05).</p><p><b>CONCLUSION</b>Radiotherapy with concurrent TMZ chemotherapy is an effective regimen with mild toxicities for treatment of adult malignant cerebral glioma.</p>