不同剂量恩度联合顺铂胸腔灌注治疗非小细胞肺癌恶性胸腔积液的效果  

MALIGNANT PLEURAL EFFUSIONS CAUSED BY NON-SMALL-CELL LUNG CANCER:TREATED WITH INTRAPLEURAL PERFUSION OF DIFFERENT DOSAGES OF ENDOSTAR PLUS CISPLATIN

作　　者：郭宝玲[1] 陈志勇[1] 郑秋香[1] 

机构地区：[1]福建医科大学附属龙岩市第一医院肿瘤内科,福建龙岩364000

出　　处：《齐鲁医学杂志》2016年第2期148-151,共4页Medical Journal of Qilu

摘　　要：目的探讨不同剂量重组人血管内皮抑制素（恩度）联合顺铂胸腔灌注治疗非小细胞肺癌（NSCLC）恶性胸腔积液的临床效果和安全性。方法将84例NSCLC恶性胸腔积液病人随机分为3组。均给予常规对症支持治疗,超声定位经胸腔置管引流排尽积液后,30mg组（26例）、45mg组（28例）、60 mg组（30例）分别给予恩度30、45、60mg联合顺铂40mg/m2胸腔内灌注,每周1次,连续2~6周。比较各组近期临床疗效、毒副作用和生活质量。结果 30、45、60mg组总有效率分别为57.7%、64.3%和86.7%,60mg组近期疗效显著优于45mg组和30mg组（z=3.962、5.963,P〈0.05）。60 mg组给药次数显著少于45 mg组和30 mg组（F=8.725,t=3.111、4.037,P〈0.05）。60mg组Karnofsky评分较45 mg组和30 mg组显著提高（F=3.589,t=2.016、2.491,P〈0.05）,生存期较45mg组和30mg组明显延长（χ2=2.057、2.524,P〈0.05）。3组毒副作用发生情况差异无统计学意义（P〉0.05）。结论胸腔内灌注60mg恩度联合顺铂治疗NSCLC恶性胸腔积液可能在迅速起效、提高临床疗效、改善生活质量并延长生存期方面使病人最大获益,并且不增加毒副作用。Objective To investigate the efficacy and safety of intrapleural perfusion with different dosages of recombi- nant human endostatin （Endostar） plus cisplatin for malignant pleural effusion （MPE） caused by non-small-cell lung cancer （NSCLC）. Methods Eighty-four patients with MPE due to NSCLC were randomized to three groups as： 30 mg group （26 cases）, 45 mg group （28 cases） and 60 mg group （30 cases）. All of them were given conventional supporting therapy. A tube was inserted into thoracic cavity for drainage. After all the effusion was drained, the patients in the three groups were given Endostar 30 mg, 45 mg and 60 mg to the three groups accordingly, and cisplatin 40 mg/mz to patients in the three groups, through pleural perfusion, once a week for 2--6 weeks. The short-term efficacy, toxic and side-effects and quality of life were compared between the three groups. Results The total efficiency in 30, 45 and 60 mg groups was 86.7%, 64.3% and 57.7%, respectively. The short-term efficacy in 60 mg group was much better than that in 45 and 30 mg groups （z =3.962,5.963;Pd0.05）. The times of medication in 60 mg group was much less than that in 45 and 30 mg groups （F=8.725;t =3.111,4.037;P〈0.05）. The Karnofsky score in 60 mg group was significantly higher than that in 45 and 30 mg groups （F=3.589;t=2.016,2.491;P〈0.05）, and the life span was significantly longer （Z 2 = 2.057,2.524 ; P〈 0.05）. The difference in incidence of toxic and adverse reactions was not signi- ficant between the three groups （P〉0.05）. Conclusion Intrathoracic perfusion of 60 mg of Endostar combined with cisplatin for malignant pleural effusion, caused by NSCLS, may bring maximum benefit to patients, in terms of rapid onset, increasing therapeutic effect, improving quality of life and prolong life, and does not increase the toxic and side effects.

关 键 词：血管抑制素类 顺铂 胸腔积液 恶性 癌 非小细胞肺 化学疗法 肿瘤 局部灌注 

分 类 号：R734.205[医药卫生—肿瘤]