奈达铂在恶性胸腔积液胸腔热灌注化疗中的应用

  目的  探讨奈达铂胸腔热灌注化疗治疗恶性胸腔积液的疗效及不良反应。  方法  将33例恶性胸腔积液患者随机分两组进行治疗, 所有患者全部行胸腔置管引流术, 胸腔积液引流干净后行胸腔热灌注化疗, A组(奈达铂组)19例, 注入奈达铂80mg, B组(顺铂组)14例, 注入顺铂80mg, 并注意预防和处理治疗毒副反应。  结果  A组有效率89.5%, B组有效率85.7%, 两组比较无显著性差异, 两组在骨髓抑制、肝肾功能损害方面比较无显著性差异, 但在胃肠道反应方面, 奈达铂组(10.5%)较顺铂组(42.9%)低, 两组比较有显著性差异, 且奈达铂无需水化、利尿等处理。  结论  奈达铂应用于体腔热灌注化疗治疗恶性胸腔积液疗效肯定, 毒副反应低, 安全性好, 无需水化、利尿等, 临床使用方便, 有临床应用价值。 

Clinical Research on Nedaplatin Combined with CHP in Treating Malignant Pleural Effusion

  Objective  The present study aims to evaluate the efficacy and side effects of nedaplatin(NDP) combined with coelom hyperthermic perfusion chemotherapy(CHPC) in treating patients with malignant pleural effusion.  Methods  A total of 33 patients were randomized into two groups, namely, NDP group(n = 19) and diamminedichloroplatinum or cisplatin(DDP) group(n = 14).Pleural effusion from patients of both groups was drawn out of the thoracic cavity via the peripheral intravenous central catheter. CHPC and different drug medications were then administered.In the NDP group, 80 mg of NDP was administered to the pectoral cavity, whereas 80 mg of DDP was administered in the DDP group.Close attention was given to the patients to prevent and manage the side effects.  Results  The response rate(RR) was 89.5%in the NDP group(17 /19), whereas the RR was 85.7%in the DDP group(12/ 14).No significant differences between the RR of the two groups were observed(P > 0.05).However, different effects in the gastrointestinal reactions were observed.The gastrointestinal reaction rate was lower in the NDP group(10.5%) compared with the DDP group(42.9%).No significant differences in the side effects in the medulla, liver, and nephridium were observed between the two groups(P > 0.05).Hydration and diuresis were not needed during NDP administration.  Conclusion  The regimen of NDP combined with CHPC is effective in treating patients with malignant pleural effusion.Without hydration and diuresis in the treatment, this regimen has little toxicity and can be easily used for extensive clinical applications.