Clinical Observation Of The Two Schemes Neaoadjuvan Chemotherapy Combined With Surgical Treatment Of Non-Small Cell Lung Cancer

Objective:To explore the clinical efficacy of gemcitabine+cisplatin, and Pemetrexed+cisplatin both schemes neoadjuvant chemotherapy combined surgical treatment of non-small cell lung cancer.Methods:Retrospective study from January2007to December2011non-small cell lung cancer patients in Guangxi Tumor Hospital, Thoracic Surgery and First Affiliated Hospital of cardiothoracic surgical treatment of220cases, of which,140patients were first preoperative neoadjuvant chemotherapy,76routine gemcitabine plus cisplatin chemotherapy scheme (gemcitabine group),64pemetrexed plus cisplatin chemotherapy scheme (pemetrexed group), both groups do preoperatie chemotherapy two cycle, the chemotherapy for three to four weeks after surgery treatment.80patients directly go to surgery (control group). Comparison of its adverse reactions in chemotherapy, chemotherapy effectiveness, intraoperative situation, postoperative complications, disease rate, surgical excision rate cut period and postoperative survival rate among different.Results:Two groups of preoperative neoadjuvant chemotherapy adverse reactions, Ⅲ-Ⅳ degrees white blood cells reduce incidence gemcitabine group23.68%higher than the9.37%which pemetrexed group (P<0.05), and hair loss, mild liver, kidney damage and Ⅲ-Ⅳ degrees Gastrointestinal reactions compares there are no significant difference (P>0.05); Chemotherapy effective rate of gemcitabine group is55.26%, the pemetrexed group is56.25%; Cut the rate of disease for gemcitabine group is35.26%, the pemetrexed group is46.88%; Surgical resection, gemcitabine group is92.65%, pemetrexed group is94.83%, to85.00%in the control group. Three groups of blood loss surgery, operation time, postoperative chest tube duration, the average hospital date and complications is there are no significant difference (P>0.05), two groups of neoadjuvant chemotherapy group postoperative24hours from chest are higher than the flow control group (P<0.05); Gemcitabine after group1,2,3year survival rates were89.47%、73.68%and68.42%, after which the pemetrexed group1,2,3year survival rates were90.60%、79.68%and70.31%, and the control group were86.25%、62.50%and47.50%, two groups of neoadjuvant chemotherapy group began survival rate are higher than the control group (P<0.05).Conclusion:1, gemcitabine, pemetrexed respectively joint cisplatin for NSCLC preoperative neoadjuvant chemotherapy treatment is effective, can reduce the Clinical stages of NSCLC, improve operation excision rate and improve the postoperative long-term survival.2, gemcitabine, pemetrexed respectively joint cisplatin for NSCLC preoperative neoadjuvant of anthracia the formation of fibrosis、the organization edema to a certain extent caused by the surgical anatomy blurred.but it not increase the surgical difficulty and postoperative complications.3, gemcitabine, pemetrexed respectively joint cisplatin for NSCLC neoadjuvant chemotherapy result is positive, the two schemes can be used as NSCLC preoperative neoadjuvant chemotherapy can choose scheme.4, pemetrexed joint cisplatin for preoperative neoadjuvant treatment of non-small cell lung cancer, the effect is with gemcitabine+cisplatin in Adverse reactions to reduce the heavy economic burden.