双路径化疗治疗老年人恶性胸腔积液40例临床分析

目的探讨胸膜腔（以下简称胸腔）置管引流并双路径化疗治疗老年恶性胸膜腔积液（以下简称胸腔积液）的疗效及不良反应。方法40例肺癌并恶性胸腔积液的老年病人，Ps评分1-2分，行胸腔置管引流术后，胸腔内灌注博莱霉素（BLM）每次60mg，lL-2每次200万IU，1次／wk，同步吉西他滨单药化疗（800—1000mg／m^2，ivdrip，d1，d8，d15，每4wk重复），观察不良反应，2周期后评价疗效。结果全组有效率为85．0％（34／40），CR10例（25％），PR24例（60％），NR6例（15％），中位生存期10mo，主要不良反应为I—II°血小板减少及皮疹。结论胸腔置管引流并双路径化疗治疗老年恶性胸腔积液疗效好，不良反应较轻，是一种可行有效的综合治疗方法。

Clinical analysis of double-way chemotherapy in treating malignant pleurai effusion in 40 cases of geriatric patients

Objective To evaluate the therapeutic effects and adverse reactions of tube thoracostomy drainage and double-way chemotherapy in treating malignant pleural effusion in geriatric. Methods 40 cases of geriatric diagnosed as malignant pleural effusion induced by lung cancer, performance status remark 1-2 score, after placement tube drainage of thoracocentesis, intrapleural injection of Bleomycin 60mg per time） and IL-2 2×10^7 IU per time）,once a week, single drug chemotherapy of gemcitabine （800-1 000mg/m^2 iv drop on days 1, 8 and 15, q 4week） concurrently, the adverse reactions were observed and therapeutic efficacy was evaluated after two cycles. Results The effective rate was[85.0% （34/40）], 10 cases of CR （25%）, 24 cases of PR （60%）, 6 cases of NR（15%）, the median survival time was 10 months, the major adverse effect was I-II degree platelet reduce and skin eruption. Conclusions Tube thoracostomy drainage and double-way chemotherapy in treating malignant pleural effusion in geriatric shows good efficacy, the toxicity is relative mild, is a kind of feasible and effective comprehensive method.