奥希替尼联合顺铂胸腔灌注治疗携带EGFR突变晚期肺腺癌并恶性胸腔积液的临床研究  

Clinical Study of Osimertinib Combined with Cisplatin Pleural Infusion Chemotherapy in the Treatment of Advanced Lung Adenocarcinoma with Malignant Pleural Effusion Carrying EGFR Mutation

作　　者：王永兵 陈泽刚 周泉 王长勇 张平 莫小飞 WANG Yongbing;CHEN Zegang;ZHOU Quan;WANG Changyong;ZHANG Ping;MO Xiaofei(Chongqing Liangping District People’s Hospital,Chongqing 405200,China)

机构地区：[1]重庆市梁平区人民医院,重庆405200 [2]重庆大学附属三峡医院

出　　处：《中国医学创新》2022年第33期13-17,共5页Medical Innovation of China

基　　金：重庆市重点疾病防治技术攻关课题(2019ZX002)。

摘　　要：目的:探讨奥希替尼联合顺铂胸腔灌注治疗携带表皮生长因子受体(EGFR)突变晚期肺腺癌并恶性胸腔积液的近期疗效和不良反应。方法:选取2020年3月-2021年10月重庆市梁平区人民医院及重庆大学附属三峡医院携带EGFR突变晚期肺腺癌并恶性胸腔积液患者52例,采用简单随机分组法分为研究组和对照组,每组26例。研究组给予奥希替尼口服靶向治疗,联合胸腔积液引流后顺铂胸腔灌注化疗,对照组仅给予奥希替尼口服联合单纯胸腔积液引流。局部治疗结束1个月后,观察两种方法对近期胸腔积液控制率、体力状况评分(PS评分)的影响,并记录不良反应发生情况。结果:研究组、对照组胸腔积液控制率分别为92.0%和68.0%,PS评分由2~3分降为0~1分的患者改善率分别为95.0%和60.0%,两组差异均有统计学意义(P<0.05)。研究组消化道不良反应发生率为60.0%,高于对照组的24.0%(P<0.05),但多以Ⅰ、Ⅱ级为主,两组白细胞减少发生率比较,差异无统计学意义(P>0.05)。结论:奥希替尼联合顺铂胸腔灌注治疗EGFR突变晚期肺腺癌并恶性胸腔积液较奥希替尼联合单纯胸腔积液引流,可提高胸腔积液控制率,改善患者体力状况,在一定程度上会增加胃肠道不良反应,但多以Ⅰ、Ⅱ级为主,值得临床应用和进一步探讨研究。Objective:To investigate the short-term efficacy and adverse reactions of Osimertinib combined with Cisplatin pleural infusion chemotherapy in the treatment of advanced lung adenocarcinoma with malignant pleural effusion carrying EGFR mutation.Method:A total of 52 patients with advanced lung adenocarcinoma with malignant pleural effusion carrying EGFR mutation in Chongqing Liangping District People’s Hospital and Three Gorges Hospital Affiliated to Chongqing University from March 2020 to October 2021 were selected,they were randomly divided into study group and control group,with 26 cases in each group.The study group was given targeted oral therapy of Osimertinib combined with Cisplatin pleural infusion chemotherapy after pleural effusion,while the control group was only given oral therapy of Osimertinib combined with pleural effusion alone.One month after the local treatment,the effects of the two methods on the recent hydrothorax control rate and performance status score(PS score)were observed,the adverse reactions were recorded.Result:The control rates of hydrothorax in the study group and the control group were 92.0%and 68.0%respectively,the improvement rates of patients whose PS scores decreased from 2-3 points to 0-1 point were 95.0%and 60.0%respectively,the differences were statistically significant(P<0.05).The incidence rate of gastrointestinal adverse reactions in the study group was 60.0%,which was higher than 24.0%of the control group(P<0.05),however,the adverse reactions were mainly of gradeⅠ,Ⅱ,there was no significant difference in the incidence of leukopenia between the two groups(P>0.05).Conclusion:Compared with therapy of Osimertinib combined with pleural effusion alone,therapy of Osimertinib combined with Cisplatin pleural infusion chemotherapy in the treatment of advanced lung adenocarcinoma with malignant pleural effusion carrying EGFR mutation can improve the control rate of pleural effusion and the physical condition of patients,and increase the gastrointestinal adverse reactions to a

关 键 词：奥希替尼 肿瘤 胸腔积液 灌注化疗 靶向治疗 

分 类 号：R734.2[医药卫生—肿瘤]