恩度联合洛铂胸腔热灌注化学治疗恶性胸腔积液的近期临床观察

目的观察恩度联合洛铂胸腔热灌注化学治疗(简称化疗)恶性胸腔积液的近期疗效和不良反应。方法选择2010年1月~2012年8月60例恶性胸腔积液患者,其中男性34例,女性26例;年龄35~65岁,中位年龄50.5岁。按照随机数字法分成观察组和对照组,各30例。所有患者均行胸腔穿刺置管,充分引流胸水,观察组采用恩度30 mg+洛铂30 mg/m2行胸腔热灌注化疗,对照组单纯洛铂30 mg/m2行胸腔热灌注化疗,热疗循环温度控制在41.5℃,每次治疗时间60 min,治疗周期为7~10 d,连续治疗4次。结果观察组患者,16例获得完全缓解,9例部分缓解,总有效率为83.3%;对照组中,12例获得完全缓解,9例部分缓解,总有效率为70.0%;两组间差异有统计学意义(P0.05)。两组患者生活质量(QOL)亦有明显改善(P0.05)。两组患者Ⅲ+Ⅳ度骨髓抑制发生率差异无统计学意义(P0.05)。结论恩度联合洛铂胸腔热灌注化疗恶性胸腔积液疗效显著,QOL改善明显,不良反应轻,值得推广应用。

Clinical observation of pleural hyperthermic perfusion chemotherapy with Endostar and Lobaplatin for treatment of malignant pleural effusion

Objective To observe the short-term curative effect and adverse events of pleural hyperthermia perfusion chemotherapy with Endostar and Lobaplatin for treatment of malignant pleural effusion. Methods A total of 60 patients with malignant pleural effusion from January 2010 to August 2012 were enrolled, which included 34 males and 26 females, aged 35- 65 years old with median age of 50.5. They were randomly divided into observation group（n = 30） and control group（n = 30）, all of them were performed thoracentesis catheter and adequate drainage of pleural effusion in advance. The observation group was treated with pleural hyperthermia perfusion chemotherapy with 30 mg of Endostar and 30 mg/m^2 of Lobaplatin, whereas the control group received pleural hyperthermia perfusion chemotherapy with 30 mg/m2 of Lobaplatin. The temperature of hyperthermia circle was controlled at 41.5 ℃ for 60 minutes in each treatment, and repeated every 7-day to 10-day for 4 times. Results In observation group, 16 cases achieved complete remission（CR） and 9 cases showed partial remission（PR）, the total response rate was 83.3 %. In control group, 12 cases got CR and 9 of PR, the total response rate was 70.0 %, and there was statistically significant difference between2 groups（P〈0.05）. The difference in improvement of quality of life（QOL） was also statistically significant between 2 groups（P〈 0.05）.There was no significant difference in incidences of Ⅲ ＋ Ⅳ myelosuppression between 2 groups（P 〉0.05）. Conclusion It is demonstrated that pleural hyperthermia perfusion chemotherapy with Endostar and Lobaplatin for treating malignant pleural effusion is effective in improving treatment outcome and QOL, but with slight adverse reactions, which is worth further investigation.