The Efficiency And Safty Of Local Chemotherapy With Operation In Combined Therapy Of LANSCLC

Objective:To evaluate the efficiency and safty of local chemotherapy with operation in combined therapy of LANSCLC(locally advanced non-small cell lung cancer).Methods:32 patients were randomly divided into two groups, i.e. control group C and experimental group E,who were diagnosed primary LANSCLC after operation.Spraying Oxaliplatm-Fibrin-Sealant-Matrix on the tumor bed and operative raw surface where was involved and/or involved dubiously before the radical operation's finish in Group E,while take radical operation merely in group C. Serum CEA(carcinoembryonic antigen) and CYFRA21-1 (serum cytokeratin 19 fragment) levels were measured on the 1^st day of pre-operation and the 6^th day of post-operation respectively in all patients and to compare whether the peri-operative changements have statistic disparity between the two groups. Furthermore, to compare whether there was obviously disparity between the two groups that on the peri-operative changements of liver function and renal function, the incident information of toxicity of chemotherapy, the time of pulling out thorax closed drainage tube, the incidence rates of post-operative complication in a week, the incidence rates of local recurrence, distant metastasis and mortality in half an year. Based on the comparisons, to evaluate the efficiency and safty of local chemotherapy with operation in combined therapy of LANSCLC.Results: (1)The pre-operative serum CEA levels between both two groups were no statistic disparity(P > 0.05) while both of the post-operative had descended markedly, furthermore, the descending amplitude in group E was greater than in group C which had obvious disparity(P=0.003).(2)The pre-operative serum CYFRA21-1 levels between both groups were no statistic disparity(P>0.05),however,the post-operative ascended appreciably in group E while it descended markedly in group C which had obvious disparity(P=0.000).(3) The peri-operative changement of ALT,AST,BUN and CR were no statistic disparity between the two groups(P> 0.05).(4)The peri-operative changement of WBC,GRN, RBC,HGB and PLT were no statistic disparity between the two groups(P>0.05).(5)The time of pulling out thoracic close drainage tube in group E was longer than in group C (P<0.047),which did not delay rehabilitation.(6)3 patients arose mild nausea symptom and 2 patients arose mild diarrhoea symptom in group E while 1 patients arose mild diarrhoea symptom in group E merely in first week after operation.The others did not arise any toxicity of chemotherapy in both groups.(7)In addition to 2 patients arose different degree pneumonia singly in both groups, nobody arose empyema,bronchopleural fistula and incision infection. Furthermore, in 6 months after operation,3 patients recrudesced locally in group C while there was only 1 patient in group E,but nobody arose distant metastasis and died.Conclusions: (1)There is some efficiency that local chemotherapy with operation in combined therapy of LANSCLC,which can heighten operative effect. It is satisfying in the near future.(2) Local chemotherapy with operation is a safe therapy method which all patients can endure it.(3)Oxaliplatin-Fibrin-Sealant- Matrix can be used in local chemotherapy with operation of LANSCLC.