Clinical efficacy analysis of preoperative neoadjuvant chemotherapy in patients with pulmonary adenocarcinoma during stage IIIA.

Abstract

128 Background: The purpose of this study is to compare the effectiveness and safety of neoadjuvant chemotherapy with targeted therapy. In order to explore the best treatment mode of lung cancer in local progression period. Methods: 42 patients with stage IIIA lung adenocarcinoma who were admitted to the Cancer Hospital of Jilin Province from 2015 to 2017 were retrospectively analyzed. They received at least 2 cycles of neoadjuvant chemotherapy or at least 6 weeks of new adjuvant targeted therapy before surgery. Results: 42 patients who met the criteria were included in this study, all of them were stage IIIA lung adenocarcinoma. Of the total number of cases, a total of 13 patients received preoperative assisted single drug EGFR-TKI treatment (including Eluotini) and 27 patients received preoperative assisted chemotherapy. Two patients received neoadjuvant chemotherapy before receiving new adjuvant targeted therapy. In patients with EGFR sensitive mutations in stage IIIA, the objective remission rate of newly assisted TKI therapy was 63.2 %, while neoadjuvant chemotherapy was 36.8 % (P = 0.021). Of the 13 patients who received new assisted targeted treatment before surgery, 11 patients continued to receive targeted treatment after the first efficacy evaluation (3 weeks): After the first efficacy evaluation PR case continued to be treated with TKI The tumor can continue to shrink until 3 months, However, there was no significant change in tumor size after the first evaluation of SD continued with TKI treatment. There was no difference between the two groups in postoperative complications, postoperative pleural drainage and postoperative hospitalization time. Conclusions: Compared with preoperative neoadjuvant chemotherapy, neoadjuvant targeted therapy has a good effect in patients with pulmonary adenocarcinoma with EGFR mutation in stage IIIA. Patients with partial remission for the first treatment evaluation can try to continue TKI treatment for 1 month after surgical resection.