重组人血管内皮抑制素治疗恶性胸腹腔积液的临床观察

目的：观察重组人血管内皮抑制素（恩度）治疗恶性胸腹腔积液的近期疗效，评价恩度局部应用的安全性和耐受性。方法：对２５例伴有恶性胸腹腔积液的晚期恶性肿瘤患者，应用恩度胸腹腔灌注给药（单药组），尽可能抽出胸腹腔内积液，注入恩度３０ｍｇ，每周２～３次，治疗２～３周，待胸腹水量稳定后可以每周１次维持治疗。其中１０例患者同时接受恩度联合顺铂胸腹腔局部灌注治疗（联合组）。每２１天为１个周期。评价近期疗效、生活质量以及毒副反应。结果：２５例患者均可进行客观疗效评价及安全性评价，ＣＲ２例，ＰＲ１１例，ＳＤ６例，ＰＤ６例，客观有效率（ＲＲ）为５２％，疾病控制率（ＤＣＲ）为７６％。联合组客观有效率高于单药组，但无统计学差异。全组患者生活质量改善者有２０例，占８０％。药物相关性毒副反应不明显。结论：恩度胸腹腔灌注给药能较好地控制恶性胸腹水，减轻临床症状。恩度与化疗药物联合局部治疗可能具有一定的协同作用，可以改善患者生活质量，安全性较好，不增加化疗药物的不良反应。

Clinical observation of endostar in the treatment of malignant serous cavity effusion

Objective：To observe the clinical efficacy of recombinant human endostatin （endostar） in the treatment of malignant thoracic effusion, and evaluate the safety and tolerability of local application of the endostar injection. Methods ： Endostar thoracic cavity perfusion（ monotherapy group）was applied in 25 cases of patients with advanced cancer. Following a maximum release of thoracic cavity fluid, endostar 30mg or along with 20ml saline could be injected in,2 or 3 times a week for 2 to 3 weeks. Then once a week for a maintainence of treatment. Among them, 10 patients at the same time received endostar thoracic cavity local chemotherapy with cisplatin（joint group）, 21 days makes a cycle. To evaluate its recent efficacy, quality of life, as well as toxicity. Results：Twenty-five cases of patients could be given an objective evaluation of the efficacy and safety, 2 cases of CR, 11 cases of PR, 6 cases of SD, 6 cases of PD with a 52% objective efficiency rate（ RR）, 76 % disease control rate（DCR） ; objective efficiency rate in the joint group was higher than the single-drug group in terms of the absolute value,but with no significant difference; In the whole group 20 cases of patients were found to improve their quality of life, accounting for 80% ; drug-related toxicity was not obvious. Conclusion：Endostar thoracic cavity infusion can better control the malignant ascites to reduce the clinical symptoms. Endostar in combination with the chemotherapy drug may play a joint role to improve the patients＇s quality of life. Clinical safety is better, with no accumulated adverse reactions.