72例胸腔内注入顺铂联合白介素2治疗恶性胸腔积液疗效对比

目的 探讨经皮胸腔内置管顺铂联合白介素2(interleukin-2,IL-2)治疗恶性胸腔积液的疗效.方法 病理确诊为恶性胸腔积液72例,经皮胸腔内置管引流排尽胸液后,分治疗组37例予IL_2 100万U,加生理盐水50 ml,顺铂按80 mg/m2,加生理盐水40 ml胸腔内注射,对照组35例患者采用顺铂80 mg/m2加生理盐水50ml胸腔内注射,注药后每周B超复查胸水情况,如胸水再积聚,则重复1次上述治疗.观察疗效、生活质量、生存率以及不良反应.结果 治疗组总有效率为83.8%,高于对照组54.3%,病变进展率8.1%,明显低于对照组25.7%,差异有统计学意义(P<0.05).Karnofsky评分大于70分治疗组疗效较对照组显著提高(P<0.05).治疗组6个月、12个月的生存率分别为92.0%、48.6%,分别高于对照组的62.9%、34.3%,其中6个月生存率差异有统计学意义(P<0.05).两组均有发热、恶心呕吐、外周白细胞减少等不良反应,但差异均无统计学意义.结论 胸腔注入IL-2及顺铂治疗恶性胸腔积液是一种疗效肯定、经济安全的方法.

Treatment of malignant pleural effusion using cisplatine and interleukin-2 intra-pleurally injection (observation of 72 cases)

Objective To evaluate the efficacy of treating malignant pleural effusion with cisplatine and interleukin-2 by injection through thoracic tube intubation. Methods 72 cases with malignant pleural effusion,after drainage,interleukin-2 1 000 000 U, cisplatine 80 mg/m2 were injected into pleural cavity in therapy group (n=37),and only cisplatine 80 mg/m2 in control group (n= 35). The tretment was repeated after a week, then the efficacy, survival rate, toxicities and quality of life were evaluated. Results The responserate was 83.8% in therapy group and 54.3% in control group. The rate of disease pre gress was 8. 1% in therapy group and 25.7 % in control group. There was statistical difference between two groups (P< 0.05). Karnofsky score was higher in therapy group than in control group. The 6,12 months survival rates were 92.0%, 48. 6% in therapy group and 62. 9%, 34.3% in control group. The adverse effect such as fever,nausea,vomiting and leukopenia occurred in both groups, but there were no significant difference in two groups. Conclusions The treatment to use interleukin-2 and cisplatine through thoracic tube is regarded as effective,slight side-effect and well tolerated method for malignant pleural effusion.