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

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.