培美曲塞与顺铂化疗联合苦参治疗胸膜间皮瘤18例报道  

Curative effect of pemetrexed combined with platinum complexes in the treatment of 18 patients with malignant pleural mesothelioma

作　　者：彭春燕[1] 彭清臻[1] 厉银平[1] 刘桂霞[1] 谢志斌[1] 

机构地区：[1]孝感市中心医院呼吸内科,湖北孝感432000

出　　处：《现代肿瘤医学》2015年第3期349-351,共3页Journal of Modern Oncology

摘　　要：目的:评价培美曲塞与顺铂静脉化疗同时联合苦参注射液胸腔灌注治疗恶性胸膜间皮瘤(MPM)合并胸腔积液的疗效与安全性。方法:回顾性分析18例经胸腔镜确诊MPM合并胸腔积液患者,使用培美曲塞500mg/m2,d1;顺铂75mg/m2,d1-3;每21天重复。同时胸腔闭式引流术引流尽胸腔积液,苦参注射液40ml胸腔注入,每隔4天重复注射。结果:18例患者中,CR 4例,PR 8例,SD 4例,PD 2例。总有效率为66.67%,疾病控制率为88.89%,肿瘤进展时间为7.2个月,中位生存期为12.3个月,1年生存率为43.85%。16例(88.89%)胸腔积液得到控制。主要毒副反应为骨髓抑制、胃肠道反应、发热、胸痛及皮疹等,对症支持处理后均可恢复。结论:培美曲塞与顺铂静脉化疗同时苦参注射液胸腔灌注治疗MPM合并胸腔积液有较好的疗效,毒副反应轻,值得临床推广应用。Objective： To evaluate the effect of pemetrexed and cisplatin chemotherapy and thoracic perfusion com- bined with matrine injection in the treatment of malignant pleural mesothelioma （MPM）. Methods ： A retrospective analysis of 18 cases of thoracoscopic pleural effusion patients diagnosed with MPM was performed. Pemetrexed 500mg/ m2, d1 , cisplatin 75mg/m2 , d1-3 ;repeated every 21 days. At the same time, closed drainage of pleural cavity drainage to pleural effusion, pleural injection of matrine injection 40ml, every 4 days repeated injection. Results ： In 18 cases, CR 4cases, PR 8cases, SD 4cases, PD 2cases. The total effective rate was 66.67% , disease control rate was 88.89% , the time to tumor progression was 7.2 months, median survival time was 12.3 months, 1 year survival rate was 43.85%. In 16 cases （88.89%） pleural effusion was controlled. The main side effects were bone marrow suppres- sion,gastrointestinal reactions, fever, chest pain and rash recovered after symptomatic treatment. Conclusion： Peme- trexed and eisplatin chemotherapy and matrine injection pleural perfusion in the treatment of MPM complicated with pleural effusion is effective and with mild side effects.

关 键 词：恶性胸膜间皮瘤 培美曲塞 胸腔积液 苦参注射液 

分 类 号：R730.262[医药卫生—肿瘤] R731[医药卫生—临床医学]