恩格菲联合羟基喜树碱胸腔灌注治疗恶性胸腔积液临床研究

目的　评价恩格菲联合羟基喜树碱治疗恶性胸腔积液的疗效及毒副作用。方法　 96例恶性胸腔积液患者随机分为 2组 ,A组单用羟基喜树碱 ,B组采取恩格菲与羟基喜树碱联合应用。 2组均采取胸腔内灌注 ,治疗后随访 18个月 ,观察比较 2组的疗效及生存率。结果　治疗后 1个月A组总有效率 (CR +PR)为 92 .0 0 % ,B组总有效率为 95 .6 0 % ,2组差异无显著性 (P >0 .0 5 ) ;6个月后A组总有效率为 5 0 .0 0 % ,B组总有效率为 76 .0 9% ,2组差异有显著性 (P <0 .0 5 )。 6个月生存率 2组均为10 0 % ;12个月生存率A组为 16 .0 0 % ,B组为 34.80 % (P <0 .0 1) ;18个月生存率A组为 2 .0 0 % ,B组为2 3.91% (P <0 .0 1)。 2组不良反应主要为胃肠道反应、胸痛和低热 ,对症处理可缓解。结论　恩格菲联合羟基喜树碱治疗恶性胸腔积液的疗效明显高于单用羟基喜树碱的疗效。

Clinical observation on malignant pleural effusion treated by intrapleural perfusion of staphylococcal entero toxin combined with hydroxycamptothecin

Objective To evaluate the therapeutic effect and safety of staphylococcal entero toxin (SE) and hydroxycamptothecin in the treatment of malignant pleural effusion. Methods 96 patients with malignant pleural effusion were randomly divided into two groups.50 patients in group A were treated only by hydroxycamptothecin;46 patients in group B were treated by SE combined with hydroxycamptothecin.The administration method was intrapleural perfusion for both groups.Follow-up was performed for 18 months,and the therapeutic effect and survival rate were observed and compared for both groups.Results In the first month after treatment,the total effective rate (CR+PR) was 92.00% in group A,and which was 95.60% in group B (P>0.05); After 6 months,which was 50.00% in group A and 76.09% in group B(P<0.05).The 6-month survival rate was 100% in both groups.The 12-month and 18-month survival rates were 16.00% and 2.00% in group A, which were 34.80% and 23.91% in group B respectively,there were significant differences between two groups(P<0.01).The main adverse reactions in both groups were gastroenteric tract reaction,thoracodynia and low fever, which could be relieved by reasonable treatment for the symptoms.Conclusion The therapeutic effect of SE combined with hydroxycamptothecin in the treatment of malignant pleural effusion is obviously superior to that of single hydroxycamptothecin.