Abstract: Objective To observe and compare the efficacy and safety of gefitinib and pemetrexed combined with nedaplatin neoadjuvant in patients with stage ⅢA-N2 EGFR mutation-positive lung adenocarcinoma.
Methods Eighty-nine patients with stage ⅢA-N2 EGFR mutation lung adenocarcinoma who were newly diagnosed in our hospital from January 2015 to May 2019 were randomly divided into a targeted therapy group（40 cases）with Gefitinib and a chemotherapy group（49 cases）with pemetrexed combined with nedaplatin.Some items were compared by the two groups，including the remission rate，effective rate of histological grade，adverse reactions incidence，the levels of surgical-related clinical indicators，postoperative complications rate，and follow-up survival rate.
Results The remission rate and effective rate of histological grade of the were higher in the gefitinib group than in the chemotherapy group（P<0.05）.The incidence of rash，diarrhea，paronychia，and oral mucositis were higher in the gefitinib group than in the chemotherapy group（P<0.05）.The incidence of nausea，vomiting，and myelosuppression were lower in the gefitinib group than in the chemotherapy group（P<0.05），and the incidence of grade Ⅲ～Ⅳ adverse reactions were lower in the gefitinib group than in the chemotherapy group（P<0.05）.There was no statistical difference in the incidence of transaminase increased and peripheral neuritis between the two groups（P>0.05）.There was no significant difference in surgical resection rate，operation time，intraoperative blood loss，and drainage tube indwelling time between the two groups（P>0.05）.There was no statistically significant difference in the incidence of postoperative complications in the two groups（P>0.05）.The median OS was significantly longer in the gefitinib group than in the chemotherapy group（P<0.05）.
Conclusion Compared with chemotherapy，gefitinib for neoadjuvant therapy in treatment of patients with lung adenocarcinoma harboring EGFR mutant at stage ⅢA-N2 stage was effective exactly，reduced the incidence of adverse reactions and significantly prolonged median survival time.

Key words: lung cancer, adenocarcinoma, epidermal growth factor receptor, neoadjuvant therapy, chemotherapy