双路径化疗治疗老年恶性胸腔积液40例临床分析

目的探讨胸腔置管引流并双路径化疗治疗老年恶性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患者，卡氏评分〉60分以上，行胸腔置管引流术后，胸腔内灌注BLM每次60mg，IL-2每次200万IU，1次／周，同步吉西他滨单药化疗（800～1000mg／m^2，ivdrip，d1，8，15，每4周重复），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10个月，主要副反应为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，副反应较轻，是一种可行有效的综合治疗方法。

Clinical analysis of double-waychemotherapy in treating 40 geriatric cases with malignant pleural effusion

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