恩度腔内灌注治疗恶性浆膜腔积液的疗效及安全性的病例对照研究  

Efficacy and safety of endostar intracavitary infusion in treatment of malignant serous cavity effusion: A case control study

作　　者：张树玲[1] 马洁韬[1] 赵健竹[1] 孙丽[1] 荆薇[1] 周洋[1] 黄乐天[1] 韩琤波[1] 

机构地区：[1]中国医科大学附属盛京医院第一肿瘤科,沈阳110022

出　　处：《中国胸心血管外科临床杂志》2018年第2期138-142,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金资助项目(81501990);辽宁省高等学校杰出青年学者成长计划项目(LJQ2014082)

摘　　要：目的分析恩度单药及恩度联合卡铂腔内灌注治疗恶性浆膜腔积液的疗效及安全性。方法回顾性分析2011年11月至2016年11月中国医科大学附属盛京医院收治的经恩度单药或恩度联合卡铂腔内灌注治疗恶性浆膜腔积液78例患者的临床资料,其中男42例、女36例,年龄62(17~78)岁。根据治疗方式将患者分为两组:恩度联合卡铂治疗组(联合用药组)33例,其中男15例、女18例,年龄56(17~66)岁;恩度单药治疗组(单药组)45例,其中男27例、女18例,年龄63(38~78)岁。分析并比较两种治疗方法的疗效及安全性。结果联合用药组和单药组有效率分别为75.8%和60.0%,差异具有统计学意义(P=0.035)。两组在生活质量改善方面差异无统计学意义(P=0.113)。在不良反应方面,单药组乏力、骨髓抑制和消化道反应的发生率明显低于联合治疗组(P=0.006,0.000,0.017)。联合用药组与单药组中位疾病进展时间(TTP)分别为171 d、143 d,差异有统计学意义(P=0.030)。结论恩度联合卡铂或恩度单药腔内灌注治疗恶性浆膜腔积液均具有较好的疗效和耐受性,对于体力状态差不能耐受铂类灌注者,可给予恩度单药灌注治疗。Objective To analyze the clinical efficacy and safety of endostar or carboplatin combined with endostar intracavitary perfusion in the treatment of malignant serous cavity effusion. Methods We retrospectively reviewed the clinical data of 78 cancer patients with malignant serous cavity effusion who received paracentesis and intracavitary endostar, or carboplatin combined with endostar in Sheng）ing Hospital of China Medical University between November 2011 and November 2016. There were 42 males and 36 females at a median age of 62 years ranging from 17 to 78 years. According to treatment methods, 78 patients were divided into two groups, in which 33 patients received intracavitary endostar combined with carboplatin （a combination group, 15 males and 18 females at a median age of 56 years ranging from 17 to 66 years）, and 45 patients received intracavitary endostar （an endostar group, 27 males and 18 females at a median age of 63 years ranging from 38 to 78 years）. The efficacy and safety of two methods were analyzed and compared. Results The response rate in the combination group was 75.8%, which was higher than that in the endostar group （60.0%, P^0.035）. In quality of life improvement, there was no statistical difference between the two groups （P=0.113）. The incidence of fatigue, myelosuppression and gastrointestinal reactions in the endostar group was significantly lower than that of the combination group （P=0.006, 0.000 and 0.017, respectively）. Analysis of long-term efficacy revealed that the median time to progress （TTP） in the combination group and endostar group was 171 days and 143 days, respectively （P=0.030）. Conclusion Intracavitary infusion of endostar alone, or carboplatin combined with endostar is effective and tolerable for controlling malignant serous cavity effusion. But for the patients with poor physical state who can not tolerant platinum perfusion, intracavitary infusion of endostar alone can be adopted to control malignant serous cavity effusion.

关 键 词：恩度 卡铂 恶性浆膜腔积液 腔内灌注 

分 类 号：R730.6[医药卫生—肿瘤]