区域亚高温热疗联合胸腔灌注顺铂治疗恶性胸腔积液

目的：观察区域亚高温热疗联合胸腔灌注顺铂治疗恶性胸腔积液的疗效及对患者生存质量的影响。方法：108例恶性胸腔积液患者随机分为热化疗组（56例）和对照组（52例），两组均先用中心静脉导管胸腔闭式引流，尽量引流尽胸水。热化疗组予以胸腔区域亚高温热疗，1周2次，热疗温度保持在40～42％，1次90min，每周第1次热疗同时结合胸腔内灌注顺铂40～60mg，第2次热疗为单纯热疗；对照组进行胸腔闭式引流后局部灌注顺铂1次40～60mg，1周1次。两组均治疗4周后评估疗效。结果：近期疗效：热化疗组有效率71．4％，对照组有效率为51．9％，两组差异有显著性意义（P〈0．05）。热化疗组中位生存期（MST）8．9个月，对照组为6．2个月；热化疗组一年生存率39．3％，对照组为34．6％，两组差异无显著性意义（P〉0．05）。生存质量评分：热化疗组治疗后比治疗前明显提高（48．08±7．32分 vs 43．76±8．32分，P〈0．05），对照组治疗后比治疗前降低（39．02±7．63分 vs 43．98±8．18分，P〈0．05）。结论：区域亚高温热疗联合胸腔灌注顺铂，有助于控制恶性胸水，提高患者生存质量。

Thermotherapy Given at Mild Temperature Combined Cisplatin Infusion for the Treatment of Malignant Pleural Effusions

Objective：To observe the therapeutic efficacy of combined mild thermotherapy and cisplatin infusion in patients with malignant pleural effusions（MPEs） and the patients＇quality of life afterwards. Methods：A total of 108 MPEs patients were randomized into combined group （56 cases） and cisplatin group （52 cases ）. After pleural effusions were adequately drained through central venous catheter, the combined group received thoracic thermotherapy （ 40 - 42℃, 90 rain every time） twice a week （with thoracie eavity infusion of cisplatin 40-60 mg for the first time and thermotherapy alone for the second time） ; the cisplatin group received cisplatin infusion of 40-60 mg once a week. The protocol period was 4 weeks. Results：Short-term outcome： the overall response rate was 71.4% for the combined group and 51.9% for the cisplatin group, with significant difference （ P 〈 0.05 ） ; the median survival time was 8.9 and 6.2 months for the combined and cisplatin groups. The one-year survival rate was 39.3 for the combined group and 34.6% for the cisplatin group with no significant difference （ P 〉 0.05 ）. Compared to it before treatment, the Karnofsky score was markedly increased in the combined group（48.08±7.32 vs 43.76±8.32, P 〈 0.05 ） but dramatically decreased in the eisplatin group （39.02±7.63 vs 43.98±8.18 ,P 〈 0.05 ）. Conclusion：Thermotherapy given at mild temperature combined with cisplatin infusion has definite effect on pleural effusions and can improve the quality of life in MPEs patients.